| NPI | 1982694196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELIX MARIO VALBUENA CEO 313-849-3920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2022-11-15 |