| NPI | 1194353789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN JAMES CAROTTA Owner 734-725-1521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103T00000X Psychologist | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2020-03-30 |