| NPI | 1851630115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN TROOP Reimbursement Officer 810-247-3496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2022-05-10 |