| NPI | 1568903268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNTAY LANESHA DIXON Board Of Director 248-471-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 820734) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |