| NPI | 1184033128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH CICHON Clinical Director 313-331-3435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MI 6802072589) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-04 |