| NPI | 1124681341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY PARK-GOEDDEKE Director 248-921-7649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-04-15 |