| NPI | 1366937435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO DAVID TILLERY CEO 517-703-3387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 251K00000X Public Health or Welfare | |
| 251T00000X PACE Provider Organization | |
| 253Z00000X In Home Supportive Care | |
| 251B00000X Case Management | |
| 251C00000X | |
| 251E00000X Home Health | |
| 251J00000X Nursing Care | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2018-06-29 |