| NPI | 1285907899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J FABIANO Executive Director 517-887-9801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MI 330225) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-02-13 |