| NPI | 1962988576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES T EDGAR Executive Director 313-894-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401007590) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2020-12-30 |