| NPI | 1003368309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNY JEAN POLING Owner/Partner 218-296-1872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MN 1083851) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2016-11-03 |