| NPI | 1982872081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RENA DAVIS Owner 734-495-3689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 6801084611) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801084611) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-19 |