| NPI | 1538543160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS KOCHIS Chief Executive Officer 313-871-1926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2024-02-08 |