| NPI | 1689331100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN HERBERT Nurse Practitioner 734-391-9968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251J00000X Nursing Care |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2022-04-12 |