| NPI | 1568999639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN PAYNE Director 517-416-2482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401011227) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2022-07-21 |