| NPI | 1790936516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LYNTON GOODE Owner 734-223-4202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301013742) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2008-10-10 |