| NPI | 1891445318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA C WILKINS Administrator 269-350-3219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-03-27 |
| Last Update Date | 2022-03-31 |