| NPI | 1831508522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK CARR Social Worker/Case Manager 313-331-3435 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 6803086187) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |