| NPI | 1366093650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA MACRAE Owner 612-306-6157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251E00000X Home Health |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 251J00000X Nursing Care | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2019-09-27 |