| NPI | 1720610777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS TELLIS Business Owner/CEO 989-332-8052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-10 |