| NPI | 1427626563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY LOUISE GREEN Secretary 586-330-0779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251J00000X Nursing Care | |
| 251V00000X Voluntary or Charitable | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-11-12 |