| NPI | 1912871716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAQIUITH NICHOLSON Owner 612-389-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 310400000X Assisted Living Facility | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| Enumeration Date | 2025-10-03 |
| Last Update Date | 2025-11-24 |