| NPI | 1568856227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA CASEY Member 810-750-5093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MI 6301008470) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2015-03-30 |