| NPI | 1114232949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANA NICOLE SUNDBERG Owner/Provider 651-433-4638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MN 1057930-2-AFC) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2010-08-17 |