| NPI | 1891327243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANA J THURMAN Administrator 269-964-3134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-05 |