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Organization

AUTHENTIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SONNY LACEY (CHIEF COMPLIANCE OFFICER)
(469) 360-3500
Entity
Organization

Contact information

Practice address
30800 TELEGRAPH RD STE 4775, BINGHAM FARMS, MI 48025-4536
(248) 469-8811
Mailing address
30800 TELEGRAPH RD STE 4775, BINGHAM FARMS, MI 48025-4536

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
01/20/2021
Last updated
01/20/2021
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