Provider Demographics
NPI:1972247252
Name:COMPASSIONATE GRACE HOMECARE LLC
Entity Type:Organization
Organization Name:COMPASSIONATE GRACE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SSEGIRINYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-210-2797
Mailing Address - Street 1:7445 FRANCE AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SOUTH EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55431-3151
Mailing Address - Country:US
Mailing Address - Phone:612-284-1811
Mailing Address - Fax:612-284-1811
Practice Address - Street 1:7445 FRANCE AVE SUITE 215
Practice Address - Street 2:
Practice Address - City:SOUTH EDINA
Practice Address - State:MN
Practice Address - Zip Code:55431-3151
Practice Address - Country:US
Practice Address - Phone:612-284-1811
Practice Address - Fax:612-284-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-23
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care