| NPI | 1194275198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVICA L THOMPSON Owner/Administrator 989-372-0691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: MI AS730384315) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |