| NPI | 1174895684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL DEWBERRY Administrator 313-881-3111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 251B00000X Case Management (Licence: MI 823182) |
| 252Y00000X Early Intervention Provider Agency (Licence: MI 823182) | |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2013-04-10 |