| NPI | 1245050020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN ELIZABETH WHITLOCK Clinical Director/Ops Manager 248-217-4419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-10-15 |
| Last Update Date | 2024-10-15 |