NPI 1801561873

Graceland Residential LLC

Organisation Adult Care Home Facility Oak Park, MI

Practice location

Address: 24220 Church St, Oak Park, MI 48237-1510
Phone: (520) 336-3026

Authorised official

Name: Sidney Atemnkeng
Title: Owner
Phone: (520) 336-3026

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

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Registry record

NPI: 1801561873
Entity type: Organization
NPI issued: 12 Aug 2021
Record last updated: 12 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.