| NPI | 1356083190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ANDERSON Owner 248-969-2914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-15 |