| NPI | 1467092528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY UHELSKI Biller 231-947-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2020-01-07 |