| NPI | 1396191177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY S JOHNSON CEO/Owner 313-316-8444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704282282) |
| Additional Taxonomies | 251E00000X Home Health (Licence: MI 4704282282) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |