| NPI | 1508324443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY GAVIN Assistant Secretary 952-983-4249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2021-02-05 |