| NPI | 1831540400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA BOSTICK Mental Health Counselor 734-660-6338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 955674) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2016-06-24 |