| NPI | 1013921014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY JORDAN Administrator 269-465-3017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MI 114170) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2008-04-20 |