| NPI | 1346954930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA ANTOINETTE HICKS Telehealth Coordinator 313-576-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-01-09 |