| NPI | 1043759111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESIE QUITON Afc Provider 616-291-4326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AM410245599) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-02-21 |