| NPI | 1952997660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KILEY SHILLING Billing Manager 517-231-3962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2020-12-17 |