| NPI | 1174778682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE BAVONESE Director 248-546-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6301007576) |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2011-05-13 |