| NPI | 1912484411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LEVENSON Owner 248-921-1348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 6801092847) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-07-26 |