| NPI | 1245690700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONEL K. SANDS Revenue Mgmt. 810-213-1803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801082542) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-02-26 |