| NPI | 1417333931 |
|---|---|
| Other Name | SELF |
| Entity Type | Organization |
| Authorized Contact | GILBERT J JOHNSON Care Giver 313-850-5205 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2015-08-06 |