| NPI | 1790819423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH WILKE Accounting & Billing Specialist 612-314-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: MN 12567) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2022-01-11 |