| NPI | 1962881532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA GAYLE BUTLER-MATTHEWS Aba 313-656-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 247200000X) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |