| NPI | 1861748238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WOLODKOWICZ Administrator 248-726-0127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2016-11-01 |