| NPI | 1922984624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSTAFA FARAH Assisted Living Director 612-836-9799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| 251S00000X Community/Behavioral Health | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 376G00000X Nursing Home Administrator | |
| 251E00000X Home Health | |
| Enumeration Date | 2025-08-15 |
| Last Update Date | 2025-09-24 |