GRACE HAVEN ASSISTED LIVING LLC (NPI# 1043589799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043589799 |
| Entity Type | Organization |
| Organization Name | GRACE HAVEN ASSISTED LIVING LLC |
| Practice Address |
301 E 3rd Street Madison MN 56256 |
| Practice Telephone | 3205987557 |
| Practice Fax Number | 3205987558 |
| Mailing Telephone | 3205987557 |
| Mailing Fax Number | 3205987558 |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2012-03-01 |
| Authorized Official Name | MRS. JENNIFER LYNN GILYARD (MANAGER) |
| Authorized Official Telephone | 3203214067 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | 355864 | MN | Nursing & Custodial Care Facilities |
| Y | 310400000X | Assisted Living Facility | 355863 | MN | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053636167 | Grace Haven Assisted Living LLC | Clinical Medical Laboratory | 1507 Glastonbury Dr, Saint Johns, MI 48879-8235 | 2010-03-31 |
| Street Address |
301 E 3RD STREET |
| City | MADISON |
| State | MN |
| Zip Code | 56256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295894269 | Roy Dewayne Hankins | Psychiatry & Neurology | 2558 271 Ave, Madison, MN 56256 | 2006-12-06 |
| 1659443679 | Kim Renae Kuechenmeister | Technician/Technologist | 323 Sixth Avenue, Madision, MN 56256 | 2006-11-14 |
| 1033209424 | City of Madison | Ambulance | 301 1st Street, Madison, MN 56256 | 2006-10-13 |
| 1376587907 | Brandon Lee Ulstad | Dentist | 622 3rd St, Madison, MN 56256 | 2006-06-15 |
| 1386741684 | Madison Healthcare Services | Home Health | 900 Second Avenue, Madison, MN 56256-1006 | 2006-09-20 |
| 1306832795 | Madison Healthcare Services | Skilled Nursing Facility | 900 2nd Ave, Madison, MN 56256-1006 | 2005-09-21 |
| 1083272066 | Victoria Marquardt | Occupational Therapist | 900 2nd Ave, Madison, MN 56256-1006 | 2019-06-04 |
| 1225548738 | Melanie Miller | Nurse Practitioner | 900 2nd Ave, Madison, MN 56256-1006 | 2017-10-10 |
| 1215308077 | Paul E Hodge | Nurse Practitioner | 900 2nd Ave, Madison, MN 56256-1006 | 2015-10-19 |
| 1326479932 | Madison Healthcare Services | Clinic/Center | 900 2nd Ave, Madison, MN 56256-1006 | 2013-12-06 |
| Find all providers in zip 56256 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215558747 | Waymaker Enterprises, LLC | Assisted Living Facility | 204 Bradfield Rd, Madison, MS 39110-7035 | 2020-05-06 |
| 1073132684 | Hope Reality, LLC | Assisted Living Facility | 5510 Forge Dr, Madison, WI 53716-2454 | 2020-04-14 |
| 1184262164 | Stacey Daniels | Assisted Living Facility | 183 Se Columbus Trl, Madison, FL 32340-3100 | 2019-12-20 |
| 1376028332 | Charlotte F Kister | Assisted Living Facility | 2358 Hubbard Road, Madison, OH 44057 | 2018-09-26 |
| 1689041865 | Crystal Fountain Home Services LLC | Assisted Living Facility | 1912 N State Road 53, Madison, FL 32340-3947 | 2015-08-24 |
| 1659755809 | Madison Senior Living, Inc. | Assisted Living Facility | 705 Ziegler Rd, Madison, WI 53714-1339 | 2015-07-17 |
| 1740690171 | Florida Assistant Living Organization, LLC | Assisted Living Facility | 219 Se Abernathy Way, Madison, FL 32340-7044 | 2014-05-07 |
| 1720498215 | Florida Assistant Living Organization, LLC | Assisted Living Facility | 585 Se Lakeshore Dr, Madison, FL 32340-2734 | 2014-05-06 |
| 1407292238 | Troyandjennyenterprises,inc | Assisted Living Facility | 765 Ne Delphinium Dr, Madison, FL 32340-5412 | 2013-05-20 |
| 1902178643 | Madison House Assisted Living | Assisted Living Facility | 3910 Dixie Hwy, Madison, GA 30650-3431 | 2012-01-26 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.