| NPI | 1194606095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ODELL Billing Specialist 248-462-0684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2026-05-02 |