| NPI | 1306288600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOORE WACHUKU Executive Director 734-743-5191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2013-07-27 |
| Last Update Date | 2013-07-27 |