| NPI | 1154776201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE ANN ODOM President Shared Services 947-522-3322 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: MI SY061207) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2021-10-21 |