| NPI | 1912362419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA RENAE MCCOY Clinical Social Worker 313-208-2430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 680408197) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2017-03-30 |