| NPI | 1023401437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY CHEROTICH GALLATI Owner 651-399-3470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: MN 1072761) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |