| NPI | 1720609621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN MOUELLE Manager 763-360-5991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2020-05-01 |