| NPI | 1366075723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA HAMBURG Clinical Therapist 248-329-3099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2020-02-13 |