| NPI | 1649924101 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | AQINYA JACKSON Phlebotomist 313-447-8708 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory | 
| Additional Taxonomies | 251E00000X Home Health | 
| 251J00000X Nursing Care | |
| 253Z00000X In Home Supportive Care | |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| Enumeration Date | 2022-02-03 | 
| Last Update Date | 2022-02-03 |