| NPI | 1710752159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HABIBO HAJI Owner 507-269-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2025-05-22 |