| NPI | 1619526100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIQUITA THOMAS Administrator 313-704-4641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2019-09-06 |