| NPI | 1013605518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANBASSA HAWIYA BUKULA Program Manager (Owner) 763-228-1804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-04-24 |