| NPI | 1982099586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYAN A LEE General Manager 269-473-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MI AF110000791) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |