| NPI | 1992359830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN R. PESHL Managing CEO 734-244-4110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QE0002X Clinic/Center, Emergency Care | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0200X Clinic/Center, Radiology | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 291U00000X Clinical Medical Laboratory | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2020-06-18 |