| NPI | 1053850776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADINE CARLSON Owner 248-342-2698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AS410317479) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: MI AS410317479) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |