| NPI | 1043695729 |
|---|---|
| Other Name | THE SHORES OF LAKE PHALEN |
| Entity Type | Organization |
| Authorized Contact | FAYE GORDON Paralegal 509-965-4240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: MN 371210) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2015-07-23 |