| NPI | 1073254033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE LYNN MAXWELL Owner 651-334-4346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |