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GRACE ASSISTED LIVING LLC
NPI 1952947269
Assisted Living Facility in Coon Rapids, MN

Active since November 21, 2019CLIA 24D2180893 · Waiver
2566 112TH AVE NW, COON RAPIDS, MN 55433(612) 227-4036 Get Directions Write a Review

NPPES record last updated: February 13, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 13, 2020, Nov 21, 2019 (2 updates tracked since 2019).

About Grace Assisted Living Llc NPPES

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

GRACE ASSISTED LIVING LLC (NPI 1952947269) is a healthcare organization registered as an assisted living facility in Coon Rapids, Minnesota and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through March 22, 2028 and lists Kefyalew F Amante, Owner, as its authorized official.

NPPES Registry Identity

NPI1952947269
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameGRACE ASSISTED LIVING LLC
Location Address2566 112TH AVE NWCoon Rapids, MN 55433-3562
Mailing Address2566 112th Ave NwCoon Rapids, MN 55433-3562 · (612) 227-4036
Phone(612) 227-4036
Organization SubpartNo
Authorized OfficialKefyalew F AmanteOwner · (612) 227-4036
Enumeration DateNovember 21, 2019
Last NPPES UpdateFebruary 13, 20202 updates tracked since enumeration
✔ NPI 1952947269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ 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.
Also ListedHome HealthTaxonomy 251E00000X
Also ListedNursing CareTaxonomy 251J00000X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedNon-emergency Medical Transport (VAN)Taxonomy 343900000X
2566 112TH AVE NW, Coon Rapids, MN 55433
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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 24D2180893

Grace Assisted Living LLC · Coon Rapids, MN
Active · expires Mar 22, 2028
CLIA Number24D2180893
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 23, 2026
Certificate Expiration DateMarch 22, 2028
Laboratory DirectorKefyalew F. Amante
Laboratory Phone(612) 888-1277
Laboratory LocationGrace Assisted Living LLC2566 112th Ave NW, Coon Rapids, MN 55433
CLIA data matches this NPI record on: Address Name
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 Grace Assisted Living LLC's NPI number?

The NPI number for Grace Assisted Living LLC is 1952947269. It was assigned to this organization in the NPPES registry on November 21, 2019.

Where is Grace Assisted Living LLC located?

Grace Assisted Living LLC is located at 2566 112th Ave NW, Coon Rapids, MN 55433. The listed phone number is (612) 227-4036.

What is Grace Assisted Living LLC's specialty?

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

Does Grace Assisted Living LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2180893) is associated with this NPI, valid through March 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grace Assisted Living LLC was last updated on February 13, 2020. 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.