Grace Group Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRACE GROUP HOME LLC

Practice address

3538 Fremont Ave N
Minneapolis, MN 55412

Phone

(612) 598-9923

NPI assigned

Jun 11, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Asia Ahmed Ali

Title

Owner/Manager

Phone

(612) 598-9923

Specialties & licenses 5

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1033778121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3538 FREMONT AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55412",
            "telephone_number": "612-598-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3538 FREMONT AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55412",
            "telephone_number": "612-598-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "ASIA",
        "authorized_official_middle_name": "AHMED",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "612-598-9923"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34790",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelynn Maire Grabau, MSN RN CNP
• John Neumann Graber, M.D.
• Lauren K Graber, M.D.
• Alec Christopher Grabinski, DDS
• Grace a. Warren DDS, Corp
• Grace Therapy Center LLC
• Grace Travel LLC
• Colleen Marie Grace, PT
• Dixie Lee Grace, PH.D.
• James Grace

• Assisted Living Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.