| NPI | 1952947269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEFYALEW F AMANTE Owner 612-227-4036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251E00000X Home Health |
| 251J00000X Nursing Care | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2020-02-13 |