| NPI | 1497267884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA RENEE PILLOW Therapist 810-285-8429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: MI 6401014779) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 6401014779) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MI 6401014779) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MI C-03160) | |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2022-11-01 |