| NPI | 1063281418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEE JACKSON Licensed Professional Counselor 313-980-1254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2025-10-30 |