| NPI | 1457884173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA MORLOCK Owner 517-281-0068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 9768) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |