| NPI | 1992128110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERENCE DALE WOOLFORK CEO 313-544-0731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-01-23 |