Organization
HURON PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LOTTIE GRACE CAFFEE (PROVIDER/OWNER)
(248) 332-1780
Entity
Organization
Contact information
Practice address
350 W HURON ST, PONTIAC, MI 48341-1422
(248) 332-1780
(248) 332-1710
Mailing address
350 W HURON ST, PONTIAC, MI 48341-1422
(248) 332-1780
(248) 332-1710
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AM630009309
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2118627
—
MI
Enumeration date
02/16/2012
Last updated
02/16/2012
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