| NPI | 1801473004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOIRA S DUVERNEAU-SALIFU Authorized Agent 952-451-2356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2021-03-26 |