| NPI | 1871344523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADUMO OMAR JAMA Director 612-203-2394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |