| NPI | 1215668843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STERLING WISE Owner 313-544-8073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-06-23 |