| NPI | 1902552680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEMMA S HAYNES CEO 586-303-7843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-04-13 |