| NPI | 1225428048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MN 370000) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: MN 371581) |
| 311ZA0620X Custodial Care Facility Adult Care Home (Licence: MN 1053221-2-AFC) | |
| Enumeration Date | 2015-02-01 |
| Last Update Date | 2015-02-01 |