| 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 |