| NPI | 1174901250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHANA NEWMAN Licensee 313-978-0499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AS820366079) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |