| NPI | 1568739159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRDELL THOMAS Director 313-588-0101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 822496) |
| Enumeration Date | 2011-11-26 |
| Last Update Date | 2014-02-27 |