| NPI | 1588979876 |
|---|---|
| Former Legal Business Name | GREAT LAKES COUNSELING SERVICE, PLLC |
| Entity Type | Organization |
| Authorized Contact | SCOTT A HALL Clinical Director 248-909-1869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 251S00000X Community/Behavioral Health (Licence: MI 6401010641) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2022-12-15 |