| NPI | 1528358728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J HERBST Sole Proprietor 734-327-9322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MI 4301057770) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 4301057770) |
| Enumeration Date | 2011-04-09 |
| Last Update Date | 2011-04-09 |