| NPI | 1225693674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA BROADWATER Manager And Owner 734-210-0308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2024-09-23 |