| NPI | 1255337796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MEYER Administrator 612-287-3538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN 00260) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2020-08-22 |