| NPI | 1154663268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA SCHIFF Director 313-924-0350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 1679663546) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2013-03-27 |