| NPI | 1881461481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEONDRA SHALAN PARKS Owner 248-845-0276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2023-12-05 |
| Last Update Date | 2023-12-05 |