| NPI | 1184609448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE E WARD Administrator 952-361-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN 328871) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2020-08-22 |