| NPI | 1003292962 |
|---|---|
| Doing Business As | KEYSTONE PRIOR LAKE |
| Entity Type | Organization |
| Authorized Contact | RYAN NOVACZYK President 952-241-8204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |