| NPI | 1699380683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH OMURWA Administrator/RN 612-481-3138 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2022-02-03 |