| NPI | 1922162759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA F HART Cef 651-688-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: MN 808486-1-RS) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |