| NPI | 1588979686 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JONATHAN AGBEBIYI CEO 248-275-3180 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MI 4301041053) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 4301041053) | 
| 208D00000X General Practice (Licence: MI 4301041053) | |
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301041053) | |
| Enumeration Date | 2010-08-12 | 
| Last Update Date | 2011-04-24 |