| NPI | 1093087801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CLARK President, Board Of Directors 313-350-2863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 822974) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: MI 4704276788) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 4704276788) | |
| 101YM0800X Counselor, Mental Health (Licence: MI 4704276788) | |
| 101YM0800X Counselor, Mental Health (Licence: MI 6801086770) | |
| 104100000X Social Worker (Licence: MI 4704276788) | |
| 163WG0000X Registered Nurse, General Practice (Licence: MI 4704276788) | |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2017-03-17 |