| NPI | 1134264435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE F. COONAN-COX Care Coordinator 586-948-0224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401005800) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |