| NPI | 1477099745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELFORD MATHEWS Counselor 131-205-3498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MI m395276) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-01-11 |