| NPI | 1356648679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY C TEACHOUT Director 248-299-2999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401010522) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MI 6401010522) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2011-02-23 |