| NPI | 1275687352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT PETER HAFDAHL President 651-641-0042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MN 10278262WS) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MN 10278242WS) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MN 10278253WS) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MN 10357212WS) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MN 10278272SILS) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MN 10278232WS) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |