| NPI | 1205326816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARA A TALASKA Owner 734-508-2806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MI 6401010650) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2020-02-03 |