| NPI | 1629318126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELMA JORDAN Owner 313-404-5004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801070324) |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2013-02-20 |