| NPI | 1104341999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAVAN YARLAGADDARAGHU PRASAD CEO 248-872-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: IL 036137175) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2024-07-10 |