| NPI | 1396141511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON WILLIAMS Member 248-943-9842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2014-11-16 |