| NPI | 1063227486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY GUNTER RUSSIAN Regional Manager, Provider Enrollme 517-253-6308 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LS0200X Nurse Practitioner School |
| Additional Taxonomies | 1041S0200X Social Worker School |
| Enumeration Date | 2025-02-12 |
| Last Update Date | 2025-02-12 |