| NPI | 1861682411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH KOSHOREK Staff Vice President 313-720-5567 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WI HMO 69002400) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2024-04-22 |