| NPI | 1922364983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIBESSO MIDHASSA DAYASSA Administrator 763-425-0228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: MN 357257) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |