| NPI | 1841905551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL A POTTER Clinical Director 248-537-2516 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 2355S0801X Specialist/Technologist Speech-Language Assistant |
| 235Z00000X Speech-Language Pathologist | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QH0700X Clinic/Center Hearing and Speech | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2024-04-19 |