| NPI | 1013707090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD ALLEN VAUGHN Administrator 231-629-9330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-14 |