| NPI | 1689385478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN PETERSON Owner 248-560-7561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2022-12-12 |