| NPI | 1255775318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA A MASON Executive Director 616-399-6293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2013-04-19 |