| NPI | 1770140196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCARLETT GRACE LANGENFELD Executive Director 218-822-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2023-02-01 |