| NPI | 1396980017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIJWANTIE SIRJU CEO/Owner 651-230-5088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MN 1047414-2-AFC) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2008-12-09 |