| NPI | 1386832491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA GIBBS Manager 313-924-9478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801061937) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2008-12-18 |