# GREATMOORE HOME CARE AGENCY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417757113
- **Authorized official:** HERMINE IRENE ADA (OWNER/PRESIDENT)
- **Authorized official phone:** (612) 231-2572

## Contact information

- **Practice address:** 433 RIVOLI DR, SAINT PAUL, MN 55130-4453
- **Practice address phone:** (612) 231-2572
- **Mailing address:** 433 RIVOLI DR, SAINT PAUL, MN 55130-4453
- **Mailing address phone:** (612) 231-2572

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/13/2025
- **Last updated:** 05/12/2025