| NPI | 1881201267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CARISSA SABO Director 810-686-1046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2020-09-29 |