| NPI | 1174041321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK S. WELLS Owner/Clinic Director 248-404-7151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 251S00000X Community/Behavioral Health | |
| 261QC1500X Clinic/Center, Community Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2024-02-01 |