| NPI | 1598502817 |
|---|---|
| Other Name | CENTRAL CITY HEALTH- DENTAL 3RD STREET |
| Entity Type | Organization |
| Authorized Contact | MICHELLE RILEY Credentialing Specialist 313-221-8595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2025-03-19 |