| NPI | 1053057109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER J SCOUTON Owner Effective 07/01/2022 218-616-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |