| NPI | 1194139261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERKALOAH AMANDA QUEEGLAY-TARPEH Registered Nurse 612-387-6629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2014-06-17 |