| NPI | 1275743205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KRESS CEO 651-699-0206 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Mentally Retarded |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2023-04-27 |