| NPI | 1588055701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRIN HANNA Cto 248-309-3402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-27 |