| NPI | 1972506335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP LORD Administrator 320-254-8215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN 9398975) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2012-01-24 |