| NPI | 1477762474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE MOORE Director 313-579-9468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301005272) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2008-10-06 |