| NPI | 1144452038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY ANNE MAHAR Director 906-228-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301073735) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801066478) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2009-10-05 |