| NPI | 1417384199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREI KATYCHEV Owner 248-470-6038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MI 4301085733) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2016-04-28 |