| NPI | 1073897641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON F BERGQUIST Business Office Manager 218-333-5514 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MN 349267) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2013-04-23 |