| NPI | 1669106423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA JEAN CECIL Owner 734-623-9716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2022-07-15 |