| NPI | 1144682634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELINA QUINTANA Clinical Social Work 734-647-8519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 6801094930) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |