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Organization

OLD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICKI BAKER (OWNER/ADMINISTRATION)
(231) 388-0092
Entity
Organization

Contact information

Practice address
924 N STATE ST, LUTHER, MI 49656-9527
(231) 388-0092
Mailing address
924 N STATE ST, LUTHER, MI 49656-9527
(231) 388-0092

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
05/29/2026
Last updated
05/29/2026
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