| NPI | 1689102931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE RUNYON Owner 616-293-7198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AS410269764) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI as410269763) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2017-05-31 |