| NPI | 1083499495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAILIE DUBOIS Co Owner 248-564-8453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2023-08-25 |