| NPI | 1619417409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA KRAJEWSKI Licensee/Designee 616-318-1961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: MI AM410285333) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |