| NPI | 1477393494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAKARA DASHELLE BOLTON-MONTGOMERY Chief Executive Officer 313-706-8768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-05-28 |