| NPI | 1326150665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BABLOO CHACKO Administrator 734-542-3150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: MI 23-6822) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |