| NPI | 1710063268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHA FORD Medical Biller 248-951-4042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2022-02-04 |