| NPI | 1255105482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMAYA SALAAD SHARDI Co Owner 651-279-7215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-11-08 |