| NPI | 1023636511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE L SMITH Owner 810-844-1850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-10-10 |