| NPI | 1003241373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIA M KOHN Owner 952-846-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MN 362790) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: MN 362790) |
| 315D00000X Hospice, Inpatient (Licence: MN 362790) | |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |