Organization
GRACIOUS HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL NGOR ONGETHI (MANAGER/OWNER)
(763) 587-5207
Entity
Organization
Contact information
Practice address
12300 WALNUT DR, ROGERS, MN 55374-4514
(763) 587-5207
(800) 948-0582
Mailing address
12300 WALNUT DR, ROGERS, MN 55374-4514
(763) 587-5207
(800) 948-0582
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
377324
MN
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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