| NPI | 1841692282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLUS ALONZO POWELL Data Specialist 313-894-8444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |