| NPI | 1124644133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA CHRISTEEN FLEIS Licensed Professional Counselor 906-282-3130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2024-01-16 |