GRACE ASSISTED LIVING LLC (NPI# 1952947269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952947269 |
| Entity Type | Organization |
| Organization Name | GRACE ASSISTED LIVING LLC |
| Practice Address |
2566 112th Ave Nw Coon Rapids MN 55433-3562 |
| Practice Telephone | 6122274036 |
| Mailing Telephone | 6122274036 |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2020-02-13 |
| Authorized Official Name | KEFYALEW F AMANTE (OWNER) |
| Authorized Official Telephone | 6122274036 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 251J00000X | Nursing Care | Agencies | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Grace Assisted living LLC | 15011 E Montview Blvd, Aurora, CO 80011 |
| Street Address |
2566 112TH AVE NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-3562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| 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 |
|---|---|---|---|---|
| 1508221136 | Autumn Glen Senior Living LLC | Assisted Living Facility | 3715 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2777 | 2015-12-26 |
| 1063797215 | Margaret Place Limited Partnership | Assisted Living Facility | 1190 117th Ave Nw, Coon Rapids, MN 55448-2383 | 2011-10-19 |
| 1235414483 | Margaret Place Limited Partnership | Assisted Living Facility | 12009 Eagle St Nw, Coon Rapids, MN 55448-1909 | 2011-10-19 |
| 1902189350 | Margaret Place Limited Partnership | Assisted Living Facility | 11777 Xeon Blvd Nw, Coon Rapids, MN 55448-2060 | 2011-09-22 |
| 1578878773 | Voa Care Centers, Minnesota | Assisted Living Facility | 1770 113th Ln Nw, Coon Rapids, MN 55433-3019 | 2010-08-11 |
| 1720252836 | Select Senior Living of Coon Rapids, LLC | Assisted Living Facility | 11350 Martin St Nw, Coon Rapids, MN 55433-3988 | 2008-04-18 |
| 1558483081 | Voa Care Centers, Minnesota | Assisted Living Facility | 11372 Robinson Dr Nw, Coon Rapids, MN 55433-3776 | 2007-04-04 |
| 1578028585 | The Homestead At Coon Rapids, Inc. | Assisted Living Facility | 11372 Robinson Dr Nw, Coon Rapids, MN 55433-4071 | 2019-02-04 |
| 1104323773 | New Western Manor Company Limited Partnership | Assisted Living Facility | 3715 Coon Rapids Blvd Nw, Coon Rapids, MN 55433 | 2018-04-10 |
| 1710262399 | Margaret Place Limited Partnership | Assisted Living Facility | 1555 118th Ln Nw, Coon Rapids, MN 55448-7579 | 2011-10-14 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on GRACE ASSISTED LIVING LLC.
| 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.