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GRACEFUL LIVING MANOR LLC
NPI 1407745201
Assisted Living Facility in Minneapolis, MN

Active since June 28, 2025CLIA 24D2319964 · Waiver
2624 BLAISDELL AVE, MINNEAPOLIS, MN 55408(952) 256-4008 Get Directions Write a Review

NPPES record last updated: June 28, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Graceful Living Manor Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACEFUL LIVING MANOR LLC (NPI 1407745201) is a healthcare organization registered as an assisted living facility in Minneapolis, Minnesota and active in the NPI registry since June 2025. The organization holds a CLIA Waiver certificate valid through March 10, 2027 and lists Abdirizak Abdulahi, Owner, as its authorized official.

NPPES Registry Identity

NPI1407745201
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameGRACEFUL LIVING MANOR LLC
Location Address2624 BLAISDELL AVEMinneapolis, MN 55408-1505
Mailing Address2624 Blaisdell AveMinneapolis, MN 55408-1505 · (952) 256-4008
Phone(952) 256-4008
Organization SubpartNo
Authorized OfficialAbdirizak AbdulahiOwner · (952) 256-4008
Enumeration DateJune 28, 2025
NPPES CertifiedJune 28, 2025
✔ NPI 1407745201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
2624 BLAISDELL AVE, Minneapolis, MN 55408
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2319964

Graceful Living Manor LLC · Minneapolis, MN
Active · expires Mar 10, 2027
CLIA Number24D2319964
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 11, 2025
Certificate Expiration DateMarch 10, 2027
Laboratory DirectorAbdirizak Abdulahi
Laboratory Phone(952) 256-4008
Laboratory LocationGraceful Living Manor LLC2624 Blaisdell Ave, Minneapolis, MN 55408
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Graceful Living Manor LLC's NPI number?

The NPI number for Graceful Living Manor LLC is 1407745201. It was assigned to this organization in the NPPES registry on June 28, 2025.

Where is Graceful Living Manor LLC located?

Graceful Living Manor LLC is located at 2624 Blaisdell Ave, Minneapolis, MN 55408. The listed phone number is (952) 256-4008.

What is Graceful Living Manor LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Graceful Living Manor LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2319964) is associated with this NPI, valid through March 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Graceful Living Manor LLC was last updated on June 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.