| NPI | 1861692824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE ELAINE WALLS-BROWN Clinical Therapist 313-610-5711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 6801080183) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |