| NPI | 1770456659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY BURTON Vice President 248-946-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 253Z00000X In Home Supportive Care | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2025-09-26 |
| Last Update Date | 2025-09-26 |