| NPI | 1669932109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODERICK GILLISON Executive Director 248-802-2712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2019-03-21 |