| NPI | 1841833050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY BARKER Credentialing Manager 734-373-0849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2024-07-16 |