| NPI | 1982611562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHIPAL RAO KAKARALA CFO 313-821-2591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2015-06-24 |