OrganizationActive
Family Care at Home
NPI 1407684285 · Nursing Facility/Intermediate Care Facility · Blaine, MN
Provider details
- NPI number
- 1407684285
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Clovis Gray, Executive Director
Mailing address
4334 122nd Cir Ne
Blaine, MN 55449-2103
Registry dates
- Enumerated
- 2024-07-23
- Last updated
- 2024-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.