| NPI | 1972141406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A LEE Owner 734-377-8720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2020-05-05 |