NPI 1932196235

Grand Avenue Rest Home INC

Organisation Mental Illness Intermediate Care Facility Minneapolis, MN

Practice location

Address: 3956 Grand Ave S, Minneapolis, MN 55409-1535
Phone: (612) 824-1434
Fax: (612) 824-2219

Authorised official

Name: Nancy Lynn Soderbeck
Title: Acting Administrator
Phone: (612) 824-1434

Registered specialties

Mental Illness Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310500000X

Other Intermediate Care Facility, Mental Illness providers in Minnesota →

Registry record

NPI: 1932196235
Entity type: Organization
NPI issued: 1 Oct 2005
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.