Graceful Lodge, LLC
NPI #1629616289 in Brooklyn Center, Minnesota
Provider Information
- NPI Number
- 1629616289
- Entity Type
- Organization
- Organization Name
- Graceful Lodge, LLC
- Primary Specialty
- Home Health
- Enumeration Date
- Dec 13, 2019
- Last Updated
- Dec 15, 2019
Practice Location
- Address
- 6430 JUNE AVE N
- City
- Brooklyn Center
- State
- Minnesota
- ZIP Code
- 55429-2127
- Phone
- (763) 496-9056
Authorized Official
- Name
- DANIEL S. BREWER
- Title
- ADMINISTRATOR
- Phone
- (763) 496-9056
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
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