| NPI | 1659965291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JANDL Executive Director 651-295-0056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2021-02-24 |