Organization
GRACEHAVEN HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMED MOHAMED (OWNER)
(612) 772-7319
Entity
Organization
Contact information
Practice address
8030 OLD CEDAR AVE S STE 121, BLOOMINGTON, MN 55425-1214
(612) 804-7865
Mailing address
8030 OLD CEDAR AVE S STE 121, BLOOMINGTON, MN 55425-1214
(612) 804-7865
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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