| NPI | 1437640687 |
|---|---|
| Doing Business As | THE SOURCE |
| Entity Type | Organization |
| Authorized Contact | SHANNA JACKSON Owner/ Counselor 313-544-3513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401013761) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |