| NPI | 1558928747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS DRAKE Dho / Ed 517-887-4361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2022-04-28 |