| NPI | 1730690298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DAVIS Administrator 313-629-7551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2017-10-23 |