| NPI | 1942507520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN SARAFA Supervisor 313-893-6172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401012155) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2011-02-17 |