| NPI | 1316231657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA C ALEXANDER Owner/Operator 313-231-5871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2023-03-28 |