76th St Afc LLC
NPI #1366982159 in Caledonia, Michigan
Provider Information
- NPI Number
- 1366982159
- Entity Type
- Organization
- Organization Name
- 76th St Afc LLC
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Feb 28, 2017
- Last Updated
- Feb 28, 2017
Practice Location
Authorized Official
- Name
- DEBRA KRAJEWSKI
- Title
- LICENSEE/DESIGNEE
- Phone
- (616) 318-1961
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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