NPI | 1356978795 |
---|---|
Entity Type | Organization |
Authorized Contact | TIRFE A DEBELA Owner 612-512-1030 |
Organization Subpart ? | No |
Primary Taxonomy | 310400000X Assisted Living Facility |
Additional Taxonomies | 251E00000X Home Health |
251J00000X Nursing Care | |
343900000X Non-emergency Medical Transport (VAN) | |
Enumeration Date | 2020-03-25 |
Last Update Date | 2023-03-15 |