| NPI | 1225327802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANOU XIONG Executive Director 612-481-2146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-04-04 |