| NPI | 1144101734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON LARSON President 313-604-8765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 101YM0800X Counselor, Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-10 |