| NPI | 1629535323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL ELLENTUCK Owner/Manager 248-318-9614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2019-02-28 |