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Organization
GRACELAND RESIDENTIAL LLC
Active
Organization
GRACELAND RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIDNEY ATEMNKENG (OWNER)
(520) 336-3026
Entity
Organization
Contact information
Practice address
24220 CHURCH ST, OAK PARK, MI 48237-1510
(520) 336-3026
Mailing address
24220 CHURCH ST, OAK PARK, MI 48237-1510
(520) 336-3026
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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