| NPI | 1750718557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN SARAFA Supervisor 589-939-5016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301015509) |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2013-10-11 |