| NPI | 1134268030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA JOANNE SHRIVER CEO 320-231-2738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MN 434214300) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: MN 402971200) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2008-06-16 |