| NPI | 1174951446 |
|---|---|
| Doing Business As | GREEN ACRES LOWELL |
| Entity Type | Organization |
| Authorized Contact | KELLY JOHNSON Administrator 616-987-9115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MI AL410311105) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |