| NPI | 1760675888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATJANA TINA SAVICH Owner 586-286-9644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI D2238A) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |