| NPI | 1376741165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN ANN GAVIN Office Manager 810-987-2681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401005551) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2008-12-05 |