Organization
FAITH URGENT CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAITH JACOB MD, MBCHB (OWNER)
(248) 245-6533
Entity
Organization
Contact information
Practice address
15645 FARMINGTON RD STE B, LIVONIA, MI 48154-2851
(734) 464-7600
(734) 464-9797
Mailing address
15645 FARMINGTON RD STE B, LIVONIA, MI 48154-2851
(734) 464-7600
(734) 464-9797
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301109743
STATE LICENSE
MI
Enumeration date
09/15/2022
Last updated
09/15/2022
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