| NPI | 1629316815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATE GARDIN COO 248-788-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI D31065) |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2020-02-12 |