| NPI | 1225542608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR AWOSIKA Administrator 763-482-1487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 253Z00000X In Home Supportive Care | |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2018-03-17 |