| NPI | 1790703502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD DUANE LEIX CEO 989-667-9661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |