Healthcare Provider Details

I. General information

NPI: 1912935883
Provider Name (Legal Business Name): GRANDVIEW CHRISTIAN HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 RIVER HILLS PKWY NW
CAMBRIDGE MN
55008-3774
US

IV. Provider business mailing address

2845 HAMLINE AVE N
SAINT PAUL MN
55113-7127
US

V. Phone/Fax

Practice location:
  • Phone: 763-689-1474
  • Fax:
Mailing address:
  • Phone: 651-631-6432
  • Fax: 651-631-6122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number00294
License Number StateMN

VIII. Authorized Official

Name: MR. MARK MEYER
Title or Position: CFO
Credential:
Phone: 651-631-6102