| NPI | 1669730651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA IGWILOHI AGBATOR Manager 612-636-3286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MN 356758) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2012-04-26 |