NPI | 1164855474 |
---|---|
Entity Type | Organization |
Authorized Contact | DARCELLE CARSON CEO, Owner 734-744-9544 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2013-08-11 |
Last Update Date | 2021-08-13 |