| NPI | 1972256980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED LARKINS CEO 734-850-6914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-01-31 |