| NPI | 1225436249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON PETERSON-SCHMIT Owner 320-980-1024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: MN 1075689-HCBS) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |