| NPI | 1184872400 |
|---|---|
| Doing Business As | WATERFORD TEEN HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | BRENDA L MCCULLOCH Billing And Ta COO Rdinator 517-908-0847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-08-28 |