| NPI | 1174348247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEDREA LARRETTE CARTER Clinical Supervisor 313-241-6903 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-11-22 |
| Last Update Date | 2025-01-31 |