| 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 |