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2740 Collingwood St Ste 100 Detroit MI 48206-1473 | |
| (734) 654-2169 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2740 Collingwood St Ste 100, Detroit, Michigan |
| Authorized Official Name and Position | Christine Croley (CFO) |
| Authorized Official Contact | 7348506915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8765 Lewis Ave Temperance MI 48182-9300 Ph: (734) 850-6903 | 2740 Collingwood St Ste 100 Detroit MI 48206-1473 Ph: (734) 654-2169 |
| NPI Number | 1679195721 |
|---|---|
| Provider Enumeration Date | 05/12/2020 |
| Last Update Date | 05/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679195721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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