| NPI | 1831829118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATIECA WILLIAMS Owner 269-567-8127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2024-07-01 |