| NPI | 1679849988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M TESNER Co Owner 734-427-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401011816) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |