| NPI | 1134627722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY ROSAEN President 734-306-5143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 6301016069) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MI 6301016069) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |