GRACE PERSONAL CARE HOME LIVING INC (NPI# 1184933186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184933186 |
| Entity Type | Organization |
| Organization Name | GRACE PERSONAL CARE HOME LIVING INC |
| Practice Address |
2625 New Haven Dr Jonesboro GA 30236-2737 |
| Practice Telephone | 7704772541 |
| Practice Fax Number | 7704772541 |
| Mailing Telephone | 7704772541 |
| Mailing Fax Number | 7704772541 |
| Enumeration Date | 2010-09-25 |
| Last Update Date | 2010-09-25 |
| Authorized Official Name | DOTSE OYAREBU (DIRECTOR) |
| Authorized Official Telephone | 7704772541 |
| Authorized Official Credential | BACHELOR OF SOCI |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
031-01-132-1 | GA | Nursing & Custodial Care Facilities |
| Street Address |
2625 NEW HAVEN DR |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236-2737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962062 | Brendas Love Personal Care Home LLC | Custodial Care Facility | 8239 Queens Dr, Jonesboro, GA 30238-2946 | 2020-05-04 |
| 1750795480 | What A Day Adult Daycare | Custodial Care Facility | 177 College St, Jonesboro, GA 30236-3581 | 2014-06-20 |
| 1487858528 | Universal Investment Svc LLC | Custodial Care Facility | 246 Canterbury Dr, Jonesboro, GA 30238-2187 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174437 | United Hands Support Services | Custodial Care Facility | 735 Ridge Rd, Canton, GA 30114-4170 | 2020-11-06 |
| 1679174429 | Golden Peak Senior Living Corp | Custodial Care Facility | 411 Edmond St, Calhoun, GA 30701-5334 | 2020-11-06 |
| 1023615531 | Lillian Womble | Custodial Care Facility | 3232 Union Church Road, Warthen, GA 31094 | 2020-10-07 |
| 1750995155 | Jacqueline Dingle | Custodial Care Facility | 604 Sugarbush Cir, Savannah, GA 31406-4434 | 2020-09-02 |
| 1114549763 | Idella's Angels | Custodial Care Facility | 270 13th Ave Sw, Cairo, GA 39828-3423 | 2020-05-16 |
| 1801421094 | Lj's Personal Care Home, LLC | Custodial Care Facility | 415 E 18th St Sw, Rome, GA 30161-6544 | 2020-03-08 |
| 1356984041 | Manuel Carl Mckenzie IIi | Custodial Care Facility | 4893 Candlewood Ln, Stone Mountain, GA 30088-1605 | 2019-10-24 |
| 1457904310 | Renaissance Healthcare LLC | Custodial Care Facility | 419 Airport Rd, Griffin, GA 30224-4834 | 2019-07-19 |
| 1225697873 | Tahirah Johnston | Custodial Care Facility | 1657 Hallmark Hills Dr, Griffin, GA 30223-8790 | 2019-06-07 |
| 1508420613 | Rosa Amanda Hill | Custodial Care Facility | 1073 Davis Rd, Culloden, GA 31016-5843 | 2019-04-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.