| NPI | 1124663935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J DUBOSE CEO 586-344-0748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2019-11-15 |