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Organization
CARE GROVE SERVICES LLC
Active
Organization
CARE GROVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GURANIE BLAMA KANNEH (OWNER/ CEO)
(612) 309-4477
Entity
Organization
Contact information
Practice address
3815 BURQUEST LN, BROOKLYN CENTER, MN 55429-3028
(612) 309-4477
Mailing address
3815 BURQUEST LN, BROOKLYN CENTER, MN 55429-3028
(612) 309-4477
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251E00000X
Home Health Agency
—
NULL
251F00000X
Home Infusion Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
NULL
320700000X
Physical Disabilities Residential Treatment Facility
—
NULL
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
NULL
374U00000X
Home Health Aide
—
NULL
385HR2050X
Respite Care Camp
—
NULL
385HR2055X
Child Mental Illness Respite Care
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
385HR2065X
Child Physical Disabilities Respite Care
—
NULL
Other
Enumeration date
10/08/2024
Last updated
10/18/2024
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