MEDICARE: ACE HOMES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1144877101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACE HOMES INC

Provider Business Mailing Address
First Line	:	3425 77TH AVE N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55443-2814
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3831 BAKKEN BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55421-5056
Country	:	US
Telephone Number	:	612-323-0315
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KALEB HAILU
Credential	:
Telephone Number	:	612-702-3012

Provider Enumeration Date	:	08/23/2019
Last Update Date	:	08/23/2019

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Directions to “ACE HOMES INC ” Practice Location

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