| NPI | 1174845465 |
|---|---|
| Doing Business As | MIKKIS |
| Entity Type | Organization |
| Authorized Contact | SHANEQUA YENAE JORDAN Indepedent Contractor 313-808-3314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OH pn 115400) |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances (Licence: MI 4703101185) |
| Enumeration Date | 2010-02-27 |
| Last Update Date | 2010-02-27 |