| NPI | 1356321624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN BRUCE ANDERSON Administrator 218-385-2005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN 329990) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2020-08-22 |