| NPI | 1871029546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANN JACKSON Clinical Therapist 313-775-6335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker | |
| 251B00000X Case Management | |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |