| NPI | 1336732585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERIE M TATUM Owner 313-412-2372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2021-04-22 |