| NPI | 1235685629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH JAMES Provider Enrollment COO Rdinator 989-701-4734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2022-09-27 |