| NPI | 1427676436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO DAVID TILLERY CEO 517-703-3387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1800X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251B00000X Case Management | |
| 251C00000X | |
| 251E00000X Home Health | |
| 251K00000X Public Health or Welfare | |
| 251S00000X Community/Behavioral Health | |
| 251T00000X PACE Provider Organization | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-07-07 |