| NPI | 1194512376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SULLIVAN CEO 313-887-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2025-05-05 |