| NPI | 1881916310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA MAUREEN ANCICK Senior Application Analyst 248-858-4906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2010-02-25 |