| NPI | 1215581384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD BROOKS Owner 269-998-8183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| 103T00000X Psychologist | |
| Enumeration Date | 2019-07-27 |
| Last Update Date | 2019-07-27 |