Grace Home and Healthcare Inc

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

GRACE HOME AND HEALTHCARE INC

Practice address

1001 Lynde Dr NE
Fridley, MN 55432-5740

Phone

(763) 210-8340

NPI assigned

Nov 30, 2022

Organization subpart

No

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

Authorized official

Name

Agatha Manjoe Tumbey

Title

Partner

Phone

(763) 210-8340

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1144930199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LYNDE DR NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325740",
            "telephone_number": "763-210-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 LYNDE DR NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325740",
            "telephone_number": "763-210-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOME AND HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A",
        "authorized_official_last_name": "TUMBEY",
        "authorized_official_first_name": "AGATHA",
        "authorized_official_middle_name": "MANJOE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "763-210-8340"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Behavioral Disturbances) in Fridley, MN
• Providers in Fridley, MN by specialty
• Assisted Living Facility (Behavioral Disturbances) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.