Provider Demographics
NPI:1235763624
Name:GRAND COMPANIONS LLC
Entity Type:Organization
Organization Name:GRAND COMPANIONS LLC
Other - Org Name:SYNERGY HOMECARE EAST CENTRAL METRO AND WEST CENTRAL WI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-256-2214
Mailing Address - Street 1:724 BIELENBERG DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2620
Mailing Address - Country:US
Mailing Address - Phone:612-256-2214
Mailing Address - Fax:651-413-3000
Practice Address - Street 1:2155 WOODLANE DR STE 200
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3049
Practice Address - Country:US
Practice Address - Phone:612-256-2214
Practice Address - Fax:651-829-2368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care