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1679341770
IVY LANE RESIDENCE LLC
WYOMING, MI
NPI
1679341770
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Entity Type
Organization
Authorized Contact
NAJIB MOALIN
Director
612-232-5643
Organization Subpart ?
No
Primary Taxonomy
311ZA0620X Custodial Care Facility, Adult Care Home
Enumeration Date
2023-12-18
Last Update Date
2023-12-18
Business Address
IVY LANE RESIDENCE LLC
4897 GRENADIER DR SW
WYOMING, MI 49509-5021
Phone number: 612-232-5643
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Mailing Address
IVY LANE RESIDENCE LLC
4897 GRENADIER DR SW
WYOMING, MI 49509-5021
Phone number:
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