| NPI | 1922559665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY BROE Director 248-474-2763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401001490) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401001490) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401001490) | |
| 106H00000X Marriage & Family Therapist (Licence: MI 6401001490) | |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |