| NPI | 1881373223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELLE CLERMONT KANNEH Vice President 612-709-3880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Additional Taxonomies | 251E00000X Home Health |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-07-13 |