| NPI | 1255877668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM PARKER Program Coordinator 313-320-6489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-27 |