| NPI | 1659438851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN JOYCE COOPER Program Supervisor 734-973-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 810044) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |