| 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 |