| NPI | 1366175523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASPER MUKWADA Owner/Licensee 269-267-9739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2022-07-06 |