| NPI | 1851718720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA K HOLLOWELL WAN Ma 248-559-5640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MI 4301068963) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2014-03-27 |