| NPI | 1982637617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN POTVIN President 218-435-6205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN 331928) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: MN 331269) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2009-10-29 |