| NPI | 1245747609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANINE M MADSEN Owner 734-776-7738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: MI 6401014963) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-08 |