| NPI | 1669179545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK R DUDLEY Managing Member 989-999-8463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2025-10-11 |