| NPI | 1962712539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAO VANG Director 763-245-7701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MN 781158600) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-10-29 |