| NPI | 1023423985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAKIA NELSON Private Practitioner 810-515-6649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801084249) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2014-06-30 |