| NPI | 1477736064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVINIA RUCKES EKONG Owner 248-469-8322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 6301015337) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2016-02-02 |