| NPI | 1942454392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE MOORE Owner 313-883-7377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2008-11-12 |