| NPI | 1922185677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN MILLER Administrator 952-914-0269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 385H00000X Respite Care |
| 251E00000X Home Health | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-12-07 |