Organization · NPI-2
Heritage Grove INC
Home Health Aide · Maple Grove, MN
NPI number1508720467
StatusActive
Last updated in NPPESDec 15, 2025
Details
- NPI
- 1508720467
- Entity type
- Organization (NPI-2)
- Legal business name
- Heritage Grove INC
- Organization subpart
- No
- Enumeration date
- Dec 15, 2025
- Certification date
- Dec 14, 2025
- Last updated
- Dec 15, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | – | – | Yes |
| 251J00000X | Nursing Care | – | – |
Practice location
13555 Territorial Cir NMaple Grove, MN 55369-4304
Phone 571-789-5282
Mailing address
13555 Territorial Cir NMaple Grove, MN 55369-4304
Phone 571-789-5282
Authorized official
Fahima Abdulkadir
Owner
2023652191
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