Organization
AMERICAN INDIAN HEALTH AND FAMILY SERVICES OF SOUTHEASTERN MI INC
Active
Organization
AMERICAN INDIAN HEALTH AND FAMILY SERVICES OF SOUTHEASTERN MI INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANETA ASSAF (DIRECTOR OF FINANCE)
(313) 846-3718
Entity
Organization
Contact information
Practice address
4880 LAWNDALESTREET, DETROIT, MI 48210
(313) 846-3718
(313) 846-0150
Mailing address
PO BOX 810, DEARBORN, MI 48121
(313) 846-3718
(313) 846-0150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H21011
BCBSM PIN/FACILITY CODE
MI
Enumeration date
08/30/2006
Last updated
04/21/2023
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