| NPI | 1124267554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAVEL YOUNG Administrator 269-760-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AS390292207) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2009-02-09 |