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Organization

GRACE HAVEN SOBER LIVING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PEG KINDA (CONTRACTOR)
(612) 306-8499
Entity
Organization

Contact information

Practice address
1940 REANEY AVE E, SAINT PAUL, MN 55119-3917
(763) 415-6301
Mailing address
1772 PONDEROSA LN, NEW RICHMOND, WI 54017-6626

Taxonomy

Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary

Other

Enumeration date
07/07/2025
Last updated
07/07/2025
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