| NPI | 1255841656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAEL MARIE CHILDRESS Administrator/Program Coordinator 313-828-0125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2017-10-12 |