| NPI | 1184799736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MONDROW Controller 248-682-0741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI NJ042763) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2018-06-21 |