| NPI | 1386196806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JEAN HANSON Owner Operator 269-323-9745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: MI AF390379270) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2016-11-01 |