| NPI | 1902393598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE KENNEDY BAYS Program Director 313-404-1195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801095847) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801095847) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-04-18 |