| NPI | 1659536167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SOPKA President 810-730-0783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: MI 5201003930) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2008-07-23 |