| NPI | 1679873798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA PURRY Medical Billing Specialist 248-739-6343 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MI 4301045243) |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |