| NPI | 1568868420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD R MOORE Therapist 313-974-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI C-00896) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2014-11-05 |