| NPI | 1972535474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY COSIMO CLEMENTE Executive Director 248-932-3412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MI 631090) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MI 500371) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-11-08 |