| NPI | 1447851233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG MANTAI Ce O 810-487-5571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |