| NPI | 1548264260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGEI SHVETZOFF Director 763-537-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 2398) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2019-11-06 |