| NPI | 1962238030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORY JOHN FEETHAM Chief Operating Officer 810-931-1961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-09-13 |