| NPI | 1831434216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYANNA M LEIBERT Owner 248-605-1860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401011071) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2024-02-14 |