SOUTHERN GRACES (NPI# 1528204955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528204955 |
| Entity Type | Organization |
| Organization Name | SOUTHERN GRACES |
| Other Organization Name | PATRICIA'S RESIDENTIAL CARE |
| Practice Address |
220 Eckles St Piedmont MO 63957-1012 |
| Practice Telephone | 5732234689 |
| Practice Fax Number | 5732234689 |
| Mailing Telephone | 5732234689 |
| Mailing Fax Number | 5732234689 |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |
| Authorized Official Name | MRS. CANDACE RAE STEARNS (OWNER/ OPERATOR) |
| Authorized Official Telephone | 5732234689 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
311ZA0620X | MO | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Patricia's Residential Care | Former Legal Business Name - Organization |
| Street Address |
220 ECKLES ST |
| City | PIEDMONT |
| State | MO |
| Zip Code | 63957-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023278074 | Don and Candace Stearns | Custodial Care Facility | 220 Eckles St, Piedmont, MO 63957-1012 | 2008-06-12 |
| 1306000104 | Candace Rae Stearns | Registered Nurse | 220 Eckles St, Piedmont, MO 63957-1012 | 2008-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720624323 | Toney Drug & Wellness, LLC | Pharmacy | #1 Hals Plaza Dr, Piedmont, MO 63957 | 2019-11-19 |
| 1700432838 | April Dawn Gibson | Behavior Technician | 306 North 2nd Street, Piedmont, MO 63957 | 2019-08-14 |
| 1457844748 | Town and Country Super Market Inc | Pharmacy | #7 Hal's Plaza, Piedmont, MO 63957 | 2018-06-11 |
| 1528588522 | Ashley Dawn Janecek | Case Manager/Care Coordinator | 306 N Second St, Piedmont, MO 63957 | 2017-06-21 |
| 1649587031 | Joseph Michael Toney | Family Medicine | #1 Hals Plaza Drive, Piedmont, MO 63957 | 2010-09-07 |
| 1184825770 | Clearwater Ambulance District | Ambulance | 117 B, Piedmont, MO 63957 | 2007-05-30 |
| 1629129457 | Roy Eugene Winters | Pharmacist | #1hals Plaza, Piedmont, MO 63957 | 2007-01-16 |
| 1386655322 | Toneys Drug & Wellness, LLC | Pharmacy | 1 Hal's Plaza Drive, Piedmont, MO 63957 | 2006-08-11 |
| 1407880099 | Michael P Toney | Family Medicine | #1 Hal's Plaza Drive, Piedmont, MO 63957 | 2006-07-10 |
| 1972549053 | Poplar Bluff Regional Medical Center LLC | Clinic/Center | #1 Hal's Plaza, Piedmont, MO 63957 | 2006-06-20 |
| Find all providers in zip 63957 | ||||
| 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 |
|---|---|---|---|---|
| 1023278074 | Don and Candace Stearns | Custodial Care Facility | 220 Eckles St, Piedmont, MO 63957-1012 | 2008-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932732690 | Mingo Residential Care of Puxico LLC | Custodial Care Facility | 24080 State Highway 51, Puxico, MO 63960-8114 | 2020-02-20 |
| 1578107298 | Heart Core LLC | Custodial Care Facility | 810 Kennedy Dr, Warsaw, MO 65355 | 2019-11-06 |
| 1851956247 | Care Enterprises, LLC | Custodial Care Facility | 2034 W College St, Springfield, MO 65806-1524 | 2019-05-01 |
| 1598256653 | Barbara's Precious Generations | Custodial Care Facility | 8604 E 87th St, Raytown, MO 64138-4401 | 2018-05-24 |
| 1275057291 | Love To Life | Custodial Care Facility | 8229 N Broadway, Saint Louis, MO 63147-2323 | 2017-08-01 |
| 1932650850 | Open With Arms LLC | Custodial Care Facility | 4308 Hollow Brook Ct, Florissant, MO 63034-2880 | 2016-10-14 |
| 1376092445 | Grace Consumer Directed Services LLC | Custodial Care Facility | 1600 Heritage Lndg Ste 202a, Saint Peters, MO 63303-8488 | 2016-09-29 |
| 1649726761 | Together Cds LLC | Custodial Care Facility | 917 Delaird Dr, Saint Louis, MO 63137-2717 | 2016-08-29 |
| 1245786631 | Horizon Cds Network LLC | Custodial Care Facility | 1655 Celerity Dr, Florissant, MO 63031-8810 | 2016-08-26 |
| 1053781443 | Vanessa Williams | Custodial Care Facility | 5757 Park Ln, Saint Louis, MO 63147-1019 | 2015-09-29 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHERN GRACES.
| 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.