| NPI | 1205607843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELSON JUMA KAP-KIRWOK Owner 616-566-3803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-01-11 |