| NPI | 1023530797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE PATRITIA BREAULT Owner 763-438-5701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 253J00000X Foster Care Agency (Licence: MN 1087196-1-HCBS) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-12-27 |