| NPI | 1649708488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABRAHAM JOSHUA Administrator 616-550-6411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2022-07-21 |