| NPI | 1245804244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDIA MCDADE Owner/ Clinical Director 734-260-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2021-05-27 |