| NPI | 1598089773 |
|---|---|
| Doing Business As | CREEKWOOD TRAIL FAMILY HOME |
| Entity Type | Organization |
| Authorized Contact | CAROLYN ANN WILSON Home Care Provider 248-625-0869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI AS630277210) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2010-03-17 |