| NPI | 1366552804 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | WANETA ASSAF Director Of Finance 313-846-3718  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | 
| Additional Taxonomies | 207Q00000X Family Medicine | 
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2023-04-21 |