| NPI | 1699010405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA MICHELLE CARROLL Owner/Director 734-649-3065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801084228) |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-05 |