| NPI | 1033245402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH GASPER SPINELLA Client Care Coordinator 586-948-0224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: MI 6803085420) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |