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General NPI Number Information
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NPI Number | 1669861084
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Entity Type | Organization
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Legal Business Name | GRACE HOME HEALTH CARE
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 1520 E 66TH ST STE 1
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City | RICHFIELD
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State | MN
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Zip | 55423-2675
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Country | US
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Telephone | 612-354-3823
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 E 66TH ST STE 1
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City | RICHFIELD
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State | MN
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Zip | 55423-2675
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Country | US
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Telephone | 612-354-3823
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. HAMDI SADE AFYARE
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Credential | N/N
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Telephone | 612-354-3823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 368030
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License Number State | MN
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