| NPI | 1073669859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA J SMITH Controller 218-724-3640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |