| NPI | 1548817620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAHNIA AMINAH HARUT Owner 612-386-0942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2024-05-28 |