| NPI | 1306609854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE JACKSON President/CEO 517-410-6164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2024-09-11 |