Organization
CARE HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHIBA MINNICH (SECRETARY)
(734) 330-0330
Entity
Organization
Contact information
Practice address
702 CORNELL RD, YPSILANTI, MI 48197-2003
(734) 330-0330
Mailing address
702 CORNELL RD, YPSILANTI, MI 48197-2003
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AS810340418
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AS810340418
—
MI
Enumeration date
01/13/2017
Last updated
01/13/2017
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