| NPI | 1205042603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P GUSHO CFO Se Mi Region 248-858-6174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2017-10-05 |