| NPI | 1326362583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN P SAMMON President 612-226-7120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MN HE-01084-04) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2010-03-17 |