| NPI | 1922628874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAMDI ALI MOHAMED Owner 612-963-2576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |