| NPI | 1184307308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL A ENAIBRE Administrator/Licensee 313-258-7910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-08-14 |