Organization
FOUNTAIN OF GRACE HOME CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH EWUMI (PROGRAM DIRECTOR)
(763) 413-7200
Entity
Organization
Contact information
Practice address
13125 HASTINHS STREET NE, BLAINE, MN 55449
(763) 413-7200
(763) 413-7379
Mailing address
21067 TAYLOR ST NE, EAST BETHEL, MN 55011-4759
(763) 413-7200
(763) 413-7379
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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