Organization
GRAND B1
Active
Other names
Grateful Hearts, Sisco's Leisure Living
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA V POWELL AFC (ADMINISTRATOR)
(231) 354-6564
Entity
Organization
Contact information
Practice address
6523 N SHERIDAN RD, EDMORE, MI 48829-9726
(231) 354-6564
(231) 354-6521
Mailing address
11400 CORAL RD, CORAL, MI 49322-9649
(231) 354-6564
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
06/19/2021
Last updated
06/21/2021
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