| NPI | 1497168215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS CLARK Executive Director 313-999-4890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2014-06-09 |