# CARE GROVE SERVICES LLC

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

## Provider details

- **NPI number:** 1942029871
- **Authorized official:** GURANIE BLAMA KANNEH (OWNER/ CEO)
- **Authorized official phone:** (612) 309-4477

## Contact information

- **Practice address:** 3815 BURQUEST LN, BROOKLYN CENTER, MN 55429-3028
- **Practice address phone:** (612) 309-4477
- **Mailing address:** 3815 BURQUEST LN, BROOKLYN CENTER, MN 55429-3028
- **Mailing address phone:** (612) 309-4477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 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