| NPI | 1679189682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMELIE NGOY Administrator 763-321-9729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 253J00000X Foster Care Agency |
| 310400000X Assisted Living Facility | |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2024-12-27 |