| NPI | 1700757440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOBY CONRAD President 313-751-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-09-16 |
| Last Update Date | 2025-11-21 |