| NPI | 1568429835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD JOHNSON Administrator 313-867-1719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MI 15840) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2020-08-22 |