| NPI | 1891821658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN LOURICAS Owner 612-339-2291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MN 334826) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |