| NPI | 1114598125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAELISE HARRIS Patient Accounts Assistant Manager 734-847-3802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2021-07-09 |