| NPI | 1225814841 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MANAL OMAR Medical Director 734-716-5901 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | 
| Enumeration Date | 2023-09-08 | 
| Last Update Date | 2023-09-08 |