| NPI | 1700210440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA LATRICE RHODES Administrator 1313-361-5955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AS820321872) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |