NPI | 1578936860 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBRA YOUNG D Irector/ Counselor 313-334-9216 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 6401014398) |
Enumeration Date | 2015-11-09 |
Last Update Date | 2015-11-09 |