| NPI | 1063279834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRESSA JIBALO Owner 507-329-5751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances | |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2024-04-07 |