| NPI | 1295125433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARSHIBIA DAVIDSON Sole Proprietor 888-788-7145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health (Licence: MI D40222) | |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2025-03-12 |