Favorgrace Wellness Clinic

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

FAVORGRACE WELLNESS CLINIC

Practice address

6160 Summit Dr N Ste 231
Brooklyn Center, MN 55430-2118

Phone

(612) 570-0747

NPI assigned

Jul 15, 2025

Organization subpart

No

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

Authorized official

Name

Favorgrace NagbeNPI 1285562843

Title

Owner

Phone

(612) 570-0747

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Tutu Fiske I, DNP/PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bloomington, MN
  • NPI 1013525534

  MN, Psychiatric/Mental Health

  Medicare reassignment NPD
• Favorgrace Nagbe

  • Psychiatric/Mental Health Registered Nurse
  • Brooklyn Center, MN
  • NPI 1285562843
  NPD Authorized official

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1114818341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 SUMMIT DR N STE 231",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 SUMMIT DR N STE 231",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302118",
            "telephone_number": "612-570-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAVORGRACE WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "NAGBE",
        "authorized_official_first_name": "FAVORGRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-570-0747"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Elliot Falck, LICSW, CPRP, MA
• Lucy Adon Fallah
• Nyemade Ivana Fallah
• Family Trust Home Health, LLC
• Fastline Services
• Carol Featherstone
• Nissa L Fell, FNP
• Hawo Fiqi
• Leilani Francella Flemister
• Daylue Flomo

• All providers in Brooklyn Center, MN
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.