| NPI | 1366622615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FOLUSO AYOTUNKU ALLISON Administrator 763-432-9706 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN 337702) |
| Additional Taxonomies | 251E00000X Home Health (Licence: MN 335882) |
| Enumeration Date | 2007-11-04 |
| Last Update Date | 2009-03-09 |