| NPI | 1164599544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN GANNON Regional Director Of Michigan 734-407-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 133V00000X Dietitian, Registered | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2015-08-06 |