| NPI | 1477192268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE LAFOREST Billing Manager 313-633-4358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2019-12-27 |