Provider Demographics
NPI:1194854026
Name:RAKHMA, INC.
Entity Type:Organization
Organization Name:RAKHMA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-824-2345
Mailing Address - Street 1:4953 ALDRICH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-5352
Mailing Address - Country:US
Mailing Address - Phone:612-824-2345
Mailing Address - Fax:612-824-3165
Practice Address - Street 1:4953 ALDRICH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55419-5352
Practice Address - Country:US
Practice Address - Phone:612-824-2345
Practice Address - Fax:612-824-3165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN333403310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4990022OtherASSITED LIVING PLUS BILLI
MNAL0017OtherUCARE JOY HOME ID NUMBER
MNAL0030OtherUCARE GRACE HOUSE ID NUM.
MNAL0018OtherUCARE PEACE HOME ID NUMBE
MN14602OtherHEALTH PARTNERS AL PLUS