| NPI | 1902002272 |
|---|---|
| Doing Business As | HEARTSIDE HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | ARIANA GRACE RAYMOND Manager Provider Enrollment 734-343-1466 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2026-05-04 |