NPI | 1245520972 |
---|---|
Entity Type | Organization |
Authorized Contact | DELMA NORRIS Licensee/Administator 248-799-0891 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AS630300566) |
Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MI AS630300566) |
Enumeration Date | 2011-04-14 |
Last Update Date | 2011-04-14 |