| NPI | 1578206363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA G SHIVERS Therapist 810-650-2732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2025-05-12 |