| NPI | 1124052816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY SAMUELS Medical Director 231-242-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-01-29 |