| NPI | 1881728947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EDWAED JOHNSON Owner 313-964-2030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 822395) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |