| NPI | 1174070247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA MCBRIDE Provider 313-909-2307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: MI AS820381418) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |