| NPI | 1336628023 |
|---|---|
| Other Name | TRAVERSE VICTORIAN ASSISTED LIVING, LLC |
| Entity Type | Organization |
| Authorized Contact | WILLIAM MARTIN EDDINGTON Representative 231-218-2948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |