| NPI | 1255683660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MICHAEL BEAUCHAMP Owner/Manager 218-453-5554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2012-10-09 |