| NPI | 1093180952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARENCE PIERCE CEO 810-406-4951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2021-01-08 |