| NPI | 1851807002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACK M MCBORROUGH Administrator 763-670-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: MN 382220) |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2018-06-16 |