| NPI | 1790072817 |
|---|---|
| Other Name | CLEAN TEENS |
| Entity Type | Organization |
| Authorized Contact | JASON ANDREW SEILER Clincial Director 734-646-8426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2011-07-10 |
| Last Update Date | 2011-07-10 |