| NPI | 1982294005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMUD HAILLE Director 612-229-9512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251E00000X Home Health |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2021-01-22 |