| NPI | 1376819110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOIS MONTAGUE House Parent 810-686-1710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AM250273429) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-03-27 |