| NPI | 1629746664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NERISSA A LEGG Owner 734-431-8503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2021-11-08 |