| NPI | 1306334115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH A BOOGHOLT Chief Executive Officer 248-798-0474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |