| NPI | 1295915643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODERICK DEJUAN PETERSON CEO 734-721-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 822954) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2007-11-13 |