| NPI | 1336655182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJA BURKS Clinical Social Worker 313-492-8452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2018-08-20 |