| NPI | 1104037985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE MELVIN SCHRAW Administrator 218-878-0642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness (Licence: MN 0021) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |