| NPI | 1144582149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA LOUISE JEFFERSON Executive Director 313-623-1712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MI 302R00000x) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |