| NPI | 1568817021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK GRESHAM Owner 313-408-3006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 5315058344) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5315058344) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |