| NPI | 1154077469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZIPPORAH BOLAR Owner/Manager 313-624-6043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 253J00000X Foster Care Agency | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2022-09-02 |