| NPI | 1023559853 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | FRIDA REUBEN BOYD Owner/Licensee 269-207-5965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: MI AS390383907) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |