| NPI | 1295180834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYSHAWNDA RILEY Owner 313-974-1793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| 305R00000X Preferred Provider Organization | |
| 305S00000X Point of Service | |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-02 |