| NPI | 1619452588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLAR M HUDSON Administrator 313-407-3711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2018-09-26 |