| NPI | 1083964837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE WARD Administrator 952-361-0340 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MN 358616) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |