| NPI | 1174605273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIRDRE MICHELLE HICKS Program Director 313-207-2009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AS820263011) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2022-07-21 |