Provider Demographics
NPI:1659907152
Name:GRACE N' CARE L.L.C
Entity Type:Organization
Organization Name:GRACE N' CARE L.L.C
Other - Org Name:GRACE N' CARE L.L.C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGING EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:CYRIL
Authorized Official - Middle Name:UWAIFO
Authorized Official - Last Name:OBOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-707-2094
Mailing Address - Street 1:1405 SILVER LAKE RD NW STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-9314
Mailing Address - Country:US
Mailing Address - Phone:612-707-2094
Mailing Address - Fax:651-286-3355
Practice Address - Street 1:1405 SILVER LAKE RD NW STE 1
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-9314
Practice Address - Country:US
Practice Address - Phone:612-707-2094
Practice Address - Fax:651-286-3355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered MealsGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA557693600OtherMNDHS
MNA742990300OtherMNDHS