| NPI | 1356001804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINA M HARPER CEO 313-779-1687 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-12-25 |
| Last Update Date | 2021-12-25 |