| NPI | 1851145049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY GRAY Owner 231-720-5322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-05-13 |