| NPI | 1710250147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BOEKEMA Bookkeeper 586-293-1868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MI 4301088798) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |