| NPI | 1891389029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY SHILLING Billing Manager 517-231-3962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2021-02-28 |
| Last Update Date | 2024-09-03 |