| NPI | 1679606859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GOVAN Owner 248-524-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301007553) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2015-06-26 |