| NPI | 1740404342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY LYNN GOLLIDAY CEO 313-878-2735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801086187) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |