| NPI | 1871209791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY GAVIN Assistant Secretary/Assistant Treas 952-983-3429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251T00000X PACE Provider Organization |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2023-01-24 |