NPI | 1609654268 |
---|---|
Entity Type | Organization |
Authorized Contact | HEIDI BRITTON CEO 231-947-1112 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
363A00000X Physician Assistant | |
Enumeration Date | 2023-09-15 |
Last Update Date | 2024-02-28 |