| NPI | 1699132068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYNABABA ABETE Owner/Manager 612-990-9616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2023-06-29 |