# TRACI'S PLACE, INC.

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

## Provider details

- **NPI number:** 1740418375
- **Authorized official:** TRACI LEA FLETCHER (PRESIDENT)
- **Authorized official phone:** (651) 295-8659

## Contact information

- **Practice address:** 61816 BANNING LINE RD, ASKOV, MN 55704-4288
- **Practice address phone:** (651) 295-8659
- **Mailing address:** 61816 BANNING LINE RD, ASKOV, MN 55704-4288
- **Mailing address phone:** (651) 295-8659

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 1053045-1-WS | MN | Yes |

## Other

- **Enumeration date:** 06/22/2009
- **Last updated:** 06/22/2009