| NPI | 1669911392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADINE CARLSON Owner 248-342-2698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AS410322595) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |