| NPI | 1528655826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY BROSS Owner 734-888-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2025-06-05 |