| NPI | 1750723409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA SOARES Director Of Clinical Services 313-829-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI 4704278295) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |