NPI | 1740418375 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACI LEA FLETCHER President 651-295-8659 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MN 1053045-1-WS) |
Enumeration Date | 2009-06-22 |
Last Update Date | 2009-06-22 |