| NPI | 1295202042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RASCHA AZAKIR Clinical Social Worker 313-903-1737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |