| NPI | 1720134943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA GRIEBEL CHAVEZ CFO 313-554-0485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MI 4704195855) |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2023-04-10 |