| NPI | 1477867299 |
|---|---|
| Doing Business As | BARRETT PRODY |
| Entity Type | Organization |
| Authorized Contact | CATHY A BELLMORE Manager 218-739-2799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MN 1058161-1-AFC) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2010-08-04 |