| NPI | 1083863351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE ONSERIO MISARO Adminstrator 952-220-0647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |