| NPI | 1437191616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD BRADLEY Do 517-332-0440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2008-09-18 |