| NPI | 1891642468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHINEAS Y VANG Licensed Assisted Living Director 651-400-0063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2026-03-12 |
| Last Update Date | 2026-03-12 |