| NPI | 1740640424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN LEA WHITE Clinical Social Worker 313-270-2537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6801001948) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2016-02-24 |