| NPI | 1962022525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMESHIA JOHNSON Owner 810-597-6564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-04-23 |