| NPI | 1730433525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM TYRONE DAVIS President 651-683-2086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-02 |