| NPI | 1902154958 |
|---|---|
| Other Name | CENTRACARE |
| Entity Type | Organization |
| Authorized Contact | ALEXANDRIA ELIZABETH GREEN LUETH CEO 269-441-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 6802069397) |
| Enumeration Date | 2012-08-23 |
| Last Update Date | 2017-03-02 |