Organization
GRANDMA'S HOUSE CO. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA GILBEUNA RN (PROGRAM DIRECTOR)
(218) 671-0959
Entity
Organization
Contact information
Practice address
4016 NEVADA AVE N, NEW HOPE, MN 55427-1340
(218) 531-3846
Mailing address
4016 NEVADA AVE N, MINNEAPOLIS, MN 55427-1340
(218) 531-3846
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
Other
Enumeration date
03/31/2025
Last updated
04/01/2025
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