| NPI | 1144414970 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | YVETTE A. KOUAYARA Clinical Manager 313-340-1024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MI 5601001767) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2007-09-05 |