| NPI | 1396128088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE LYNN TILLERY Authorized Official/Office Manager 517-213-8185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801094835) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6801094835) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-02622) | |
| 103K00000X Behavior Analyst (Licence: MI 6801094835) | |
| 104100000X Social Worker (Licence: MI 6801094835) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2024-02-15 |