Organization
ACCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONA MAKKI (PROGRAM MANAGER)
(313) 584-1193
Entity
Organization
Contact information
Practice address
6451 SCHAEFER RD, DEARBORN, MI 48126-2212
(313) 584-0636
Mailing address
6451 SCHAEFER RD, DEARBORN, MI 48126-2212
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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