| NPI | 1639349657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH D RUSSELL President 586-447-0130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801012479) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2008-03-05 |