| NPI | 1750251252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY DODGE Clinical Social Worker 313-498-6994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-11-10 |
| Last Update Date | 2026-04-06 |