Organization
GRACE HAVEN ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER LYNN GILYARD (MANAGER)
(320) 321-4067
Entity
Organization
Contact information
Practice address
301 E 3RD STREET, MADISON, MN 56256
(320) 598-7557
(320) 598-7558
Mailing address
301 E 3RD STREET, MADISON, MN 56256
(320) 598-7557
(320) 598-7558
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
355863
MN
310400000X
Assisted Living Facility
355864
MN
Other
Enumeration date
12/27/2011
Last updated
03/01/2012
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