| NPI | 1750718078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE ELLEN WILDS Owner 269-695-6074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MI AM110064771) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: MI AM110064771) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |