| NPI | 1609245216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONNIE FREDERICK HARVEY Behavioral Heallth Counselor 313-372-5974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MI 6401013184) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2019-05-31 |