| NPI | 1285485698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA M RALKO Nurse Practitioner 313-629-1552 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2025-02-12 |