| NPI | 1225464498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALINDA ANN LEWIS Manager/Administrator 313-492-8566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2013-09-19 |