| NPI | 1083172985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMITRA TUMBA KAULU Owner/Manager 612-212-9212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251E00000X Home Health |
| 251J00000X Nursing Care | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332U00000X Home Delivered Meals | |
| Enumeration Date | 2019-03-10 |
| Last Update Date | 2019-03-10 |