| NPI | 1346002581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBEKAH DOVE MONTGOMERY Owner 734-255-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2024-01-24 |