| NPI | 1548501349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA BRANDELL Clinician 734-330-7629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801095127) |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2013-03-05 |