Gracehaven Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GRACEHAVEN HOME CARE LLC

Practice address

8030 Old Cedar Ave S Ste 121
Bloomington, MN 55425-1214

Phone

(612) 804-7865

NPI assigned

Aug 29, 2025

Last updated

Aug 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mohamed MohamedNPI 1215646534

Title

Owner

Phone

(612) 772-7319

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohamed Ali Mohamed

  • Non-emergency Medical Transport (VAN)
  • Richfield, MN
  • NPI 1215646534
  Authorized official Same address or phone

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1790664134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8030 OLD CEDAR AVE S STE 121",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251214",
            "telephone_number": "612-804-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8030 OLD CEDAR AVE S STE 121",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251214",
            "telephone_number": "612-804-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEHAVEN HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-772-7319",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Gosen, MD
• Mary Kathleen Gosse, M.A., REV.
• Anthony D Gottwalt
• Dorothy M Goulart, LCSW
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• Tiara Tyler-Ann Grafton
• Jillian Gramling, PT
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• Grandview Reliable Care (Grandview Reliable Care LLC.)

• Home Health Agency in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; 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.