| NPI | 1336607431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY WILLIAMSON Revenue Manager, Biller 313-390-9350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2023-12-12 |