| NPI | 1700079936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADE ADEOLA ADENUSI Director Of Nursing 651-442-8693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MN 334189) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |