| NPI | 1568846897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C BOWERS Wrap Around Facilitator 586-531-8245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MI 6401014842) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2015-07-16 |