| NPI | 1942675525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN WHITE Executive Director 989-953-5191 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2019-11-14 |