| NPI | 1891397097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH EE DUBICKI Sole Provider 248-574-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2021-08-09 |