| NPI | 1205359239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAELEEN NICOLE DAVIS Owner 248-805-1312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2022-08-08 |