| NPI | 1144180183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN BOATMON Owner 313-214-6855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 174200000X Meals |
| 251S00000X Community/Behavioral Health | |
| 385H00000X Respite Care | |
| Enumeration Date | 2025-11-13 |
| Last Update Date | 2025-11-13 |