| NPI | 1396126405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA SHORT Counselor 231-313-0773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MI 6401014304) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |