| NPI | 1861171175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARIE WASSEL Owner 734-255-3439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2024-03-11 |