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General NPI Number Information
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NPI Number | 1235763624
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Entity Type | Organization
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Legal Business Name | GRAND COMPANIONS LLC
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 2155 WOODLANE DR STE 200
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City | WOODBURY
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State | MN
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Zip | 55125-3049
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Country | US
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Telephone | 612-256-2214
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Fax | 651-829-2368
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Provider Business Mailing Address
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Address Line | 724 BIELENBERG DR
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City | WOODBURY
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State | MN
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Zip | 55125-2620
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Country | US
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Telephone | 612-256-2214
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Fax | 651-413-3000
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Authorized Official
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Title or Position | OWNER
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Name | MR. ALICIA HARMON
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Credential |
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Telephone | 612-256-2214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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