| NPI | 1669863841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA OCHULO Home Provider 313-415-3658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AS820306356) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-10 |