| NPI | 1457640930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED LARKINS Executive Director 734-850-6914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2014-10-14 |