| NPI | 1841492709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY JO GREEN Program Coordinator 586-759-7469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI vs080188) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2007-08-29 |