| NPI | 1760922637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LEE CANTER Licensee/Administator 616-897-8340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: MI AM410293632) |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |