| NPI | 1588942882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA LYNN-DIONYSIUS LARSON Occupational Therapist 320-293-3205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN 103693) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2011-08-03 |