Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] |
| NPI Number | 1649230665 |
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| LBN Legal business name | SOUTH LYON HEALTH CENTER, INC. | ||||||||
| Authorized official | CYLI RESENDIZ - (MEDICAL STAFF SUPERVISOR) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 03/24/2006 | ||||||||
| Last updated | 05/08/2025 - More than a year ago | ||||||||
| Identifiers |
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