Organization
GRACEFUL LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANA MARIE MILLER (PROVIDER)
(651) 408-1438
Entity
Organization
Contact information
Practice address
5810 CRANBERRY DR, WYOMING, MN 55092-9499
(651) 408-1438
Mailing address
5810 CRANBERRY DR, WYOMING, MN 55092-9499
(651) 408-1438
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
MN
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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