| NPI | 1336003193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE CLAIBORNE Owner 651-756-7545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-12-15 |
| Last Update Date | 2025-12-15 |