| NPI | 1114465044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA ALAME Registered Dietitian 313-912-4798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MI F0803N) |
| Enumeration Date | 2017-02-12 |
| Last Update Date | 2017-03-21 |