Organization
CAROL'S HOME AFC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL ANN SCISSOM RN (OWNER)
(269) 469-2825
Entity
Organization
Contact information
Practice address
13165 WILTON AVE, NEW BUFFALO, MI 49117-9122
(269) 469-2000
Mailing address
13165 WILTON AVE, NEW BUFFALO, MI 49117-9122
(269) 469-2000
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
AF10093402
MI
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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