| NPI | 1629616289 |
|---|---|
| Doing Business As | GRACEFUL LODGE HOME CARE |
| Entity Type | Organization |
| Authorized Contact | DANIEL S. BREWER Administrator 763-496-9056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2019-12-15 |