| NPI | 1962733089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANETTE B DAVIS Chief Financial Officer 313-871-3751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: 251K00000x) |
| Additional Taxonomies | 251S00000X |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2023-11-30 |