| NPI | 1134588668 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | TAMEKIA MABIN President 248-636-7862 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 305R00000X Preferred Provider Organization | |
| 261QP3300X Clinic/Center, Pain | |
| 251T00000X PACE Provider Organization | |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-12 |