| NPI | 1851893176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDAL L BENNETT CFO 616-929-3677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI as410392756) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI as410392760) |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI as410392759) | |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MI as410392757) | |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-03-17 |