| NPI | 1104224435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENSA MOHAMED Director 612-814-2159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: MN 1076264) |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2015-06-15 |