NPI | 1295070456 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIS RUSSELL Chief Executive Officer 810-257-3736 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
Enumeration Date | 2012-11-29 |
Last Update Date | 2025-06-05 |