| NPI | 1720252836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY J MYERS Residence Director 651-492-6535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MN 339176) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-04-18 |