| NPI | 1013269067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP UWAGWU CEO 763-412-9921 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 314000000X Skilled Nursing Facility (Licence: MN 15660842) | |
| 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric | |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2012-10-15 |