| NPI | 1679219653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL OBWAYA Owner/RN/Assit. Admin 952-649-1097 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |