| NPI | 1366562704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA MOORE Nurse 313-371-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 821005) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |