| NPI | 1356621668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS MONIQUE LEWIS Substance Abuse Therapist 586-758-6670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 6803085617) |
| Additional Taxonomies | 251S00000X (Licence: MI 1-04845) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2011-08-18 |