| NPI | 1255400339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD JAMES OESTERWIND Program Director 734-641-1141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 822965) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |