| NPI | 1255442190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE MARUICE GRAY Partner 313-371-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MI 302R00000X) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-01-23 |