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GRACEFUL LODGE, LLC
NPI 1629616289
Home Health in Brooklyn Center, MN

Active since December 13, 2019
6430 JUNE AVE N, BROOKLYN CENTER, MN 55429(763) 496-9056 Get Directions Write a Review

NPPES record last updated: December 15, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Graceful Lodge, Llc NPPES

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

GRACEFUL LODGE, LLC (NPI 1629616289), doing business as Graceful Lodge Home Care, is a healthcare organization registered as a home health in Brooklyn Center, Minnesota and active in the NPI registry since December 2019. The organization lists Daniel S. Brewer, Administrator, as its authorized official.

NPPES Registry Identity

NPI1629616289
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameGRACEFUL LODGE, LLC
Location Address6430 JUNE AVE NBrooklyn Center, MN 55429-2127
Mailing Address3300 County Road 10 Ste 320fBrooklyn Center, MN 55429-3072 · (763) 496-9056 · Fax (763) 374-3882
Phone(763) 496-9056
Organization SubpartNo
Authorized OfficialDaniel S. BrewerAdministrator · (763) 496-9056
Enumeration DateDecember 13, 2019
Last NPPES UpdateDecember 15, 2019
✔ NPI 1629616289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
6430 JUNE AVE N, Brooklyn Center, MN 55429
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Other Names 1

Doing Business AsGraceful Lodge Home Care

Other Identifiers 1

Other394111MN · Comprehensive Licensed Home Care Service

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL S. BREWER JR.
Home Health Aide
6430 JUNE AVE N
BROOKLYN CENTER, MN 55429
Hennepin County (763) 496-9056

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 Lodge, LLC's NPI number?

The NPI number for Graceful Lodge, LLC is 1629616289. It was assigned to this organization in the NPPES registry on December 13, 2019. The provider is doing business as Graceful Lodge Home Care.

Where is Graceful Lodge, LLC located?

Graceful Lodge, LLC is located at 6430 June Ave N, Brooklyn Center, MN 55429. The listed phone number is (763) 496-9056.

What is Graceful Lodge, LLC's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

When was this NPI record last updated?

The NPPES record for Graceful Lodge, LLC was last updated on December 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.