| NPI | 1124473814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE SUE ENGLAND Owner 734-224-0621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: MI 7501000854) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MI 7501004627) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2016-04-29 |