| NPI | 1720733306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIHESA MACK Owner 810-644-2128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-02-13 |
| Last Update Date | 2022-03-16 |