| NPI | 1659400240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES J ELENBAAS President 616-293-7449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-22 |