| NPI | 1043921315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MOO Program Manager 651-349-9909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 261Q00000X Clinic/Center | |
| 310400000X Assisted Living Facility | |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2024-01-18 |