| NPI | 1437417805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD RODERICK FUNDERBURG President 313-207-0278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801086140) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2012-04-24 |