| NPI | 1215684410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE TAYLOR Manager 313-671-3252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 251E00000X Home Health |
| 251F00000X Home Infusion | |
| 251J00000X Nursing Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2022-03-09 |