| NPI | 1487995791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL EDWAED HENDRICKSON Owner 218-564-4268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| 311500000X Alzheimer Center (Dementia Center) | |
| 315D00000X Hospice, Inpatient | |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-03-12 |