| NPI | 1861627507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BLANKENSHIP Program Director 517-394-7867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MI 330330) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 330330) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2012-03-22 |