| NPI | 1912330457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA THELEN Director Of Operations 616-719-5895 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MI AH800315846) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: MI AH090323912) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2015-03-09 |