| NPI | 1154754620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSTAPHA KAMBI Registered 231-343-8538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: WI 19433930) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2013-08-20 |