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1801324538
TENAGNE MENGISTU
GRAND RAPIDS, MI
NPI
1801324538
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
311ZA0620X Custodial Care Facility Adult Care Home
(Licence: MI AF410315360)
Enumeration Date
2017-05-25
Last Update Date
2017-05-25
Business Address
TENAGNE MENGISTU
604 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503-5218
Phone number: 616-589-4609
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Mailing Address
TENAGNE MENGISTU
604 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503-5218
Phone number:
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