| NPI | 1285781732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LYNN RUDNICK Supervisor 810-257-0092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: MI 6801060672) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: MI 6801060672) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |