| NPI | 1700812088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R HAAS Manager 651-464-2114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MN 2003526) |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-02-13 |