GRAND AVENUE REST HOME INC is an intermediate care facility mental illness in Minneapolis, MN. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. GRAND AVENUE REST HOME INC NPI is 1932196235. The provider is registered as an organization entity type.
The provider Other Name Is Grand Avenue Residence.
The provider's business location address is:
3956 GRAND AVE S
MINNEAPOLIS, MN
ZIP 55409-535
Phone: (612) 824-1434
Fax: (612) 824-2219
The provider's authorized official is Nancy Lynn Soderbeck .
The authorized official title is Acting Administrator and has the following contact phone number (612) 824-1434.
The CLIA number assigned to this NPI record is 24D0401704 - skilled nursing/nursing facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 10/1/2005 and was last updated on 8/22/2020.