| NPI | 1194365320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTRAIL MCCORD Owner 248-750-7739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 261QM0801X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2020-01-15 |