| NPI | 1114458221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALTAF KHONDAKAR Administrator 763-280-6652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |