| NPI | 1649261488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL DAVID GOODRICH Director Of Accounting 269-381-0560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MI 394170) |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2019-08-28 |