| NPI | 1205347291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMAR AMIR GHOSN Manager 313-903-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2017-12-09 |