| NPI | 1700086683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILDRED THIGPEN Administrator 269-373-6264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AF390084874) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |