| NPI | 1699029686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENDER K FOSTER Administrator 763-843-0982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |