| NPI | 1801345814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRICE LAVONNE WHITE-JOHNSON Clinical Therapist 313-687-7506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 302R00000X Health Maintenance Organization | |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2016-10-03 |