| NPI | 1124196415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY WILLIS COLSTON CEO 313-864-2987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801034096) |
| Enumeration Date | 2006-12-03 |
| Last Update Date | 2020-08-22 |