| NPI | 1609499664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN S MUMBUWA Administrator/Owner 952-221-7318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2020-05-26 |