| NPI | 1689078610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA LEWIS-MOORE Owner/Clinical Therapist 313-506-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 6801085243) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2023-12-13 |