| NPI | 1831908755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADSTON MULUH NKWAINGUH Designated Coordinator 612-308-8775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |