| NPI | 1750339826 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | TERESA LYNN DEBEVEC Administrator 218-666-5945  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN 332006)  | 
| Enumeration Date | 2006-05-04 | 
| Last Update Date | 2019-02-27 |