Organization
POWELL HOUSE AFC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI COSTANZA RN (OWNER)
(269) 983-0300
Entity
Organization
Contact information
Practice address
3531 NILES RD, SAINT JOSEPH, MI 49085-8744
(269) 281-0034
(269) 983-0303
Mailing address
3838 NILES RD, SAINT JOSEPH, MI 49085-8612
(126) 998-3030
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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