| NPI | 1629801543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONIQUE BOAZEMAN Consultant 313-977-2767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2025-01-29 |