| NPI | 1700325339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA JEAN AMBRUS Licensee/Owner 616-724-4758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI AM410311939) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2017-02-15 |