GRACIOUS LIFE INC (NPI# 1710531611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710531611 |
| Entity Type | Organization |
| Organization Name | GRACIOUS LIFE INC |
| Practice Address |
6 Ridgewood Ct Pomona CA 91766-4830 |
| Mailing Address |
800 N Haven Ave Ste 210 Ontario CA 91764-4951 |
| Practice Telephone | 9513973106 |
| Mailing Telephone | 9094760115 |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-07-29 |
| Authorized Official Name | NA ZHAO (CFO) |
| Authorized Official Telephone | 8182670352 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Gracious Life Inc. | Former Legal Business Name - Organization |
| Street Address |
6 RIDGEWOOD CT |
| City | POMONA |
| State | CA |
| Zip Code | 91766-4830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851999494 | Justine Arce | Massage Therapist | 2063 Rancho Valley Drive Suite 320 #208, Pomona, CA 91766 | 2020-10-15 |
| 1699287938 | Monika Stephanie Wan | Pharmacist | 710 Rio Rancho Road, Pomona, CA 91766 | 2017-10-26 |
| 1306386966 | Teresa Le | Dentist | 1898 Wright St, Pomona, CA 91766 | 2017-03-02 |
| 1770971715 | Hanzel Mendez | Physical Therapist | 1080 Verbena Court, Pomona, CA 91766 | 2014-12-29 |
| 1902223589 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 3 Cottontail Dr, Pomona, CA 91766 | 2014-03-21 |
| 1487075578 | Fenix Health Medical Group, Inc. | Family Medicine | 716 East Mission Blvd., Pomona, CA 91766 | 2013-12-17 |
| 1134556012 | Imperial Hospice, Inc. | Hospice Care, Community Based | 363 S Park Ave Ste 105, Pomona, CA 91766 | 2013-10-08 |
| 1497196349 | Cohen Sedgh, Manavi & Pakravan Dental Corporation | Dentist | 763 Rio Rancho Road Suite120, Pomona, CA 91766 | 2013-07-08 |
| 1245573567 | Terry Chang | Acupuncturist | 3060 W. Temple Ave., Pomona, CA 91766 | 2013-04-04 |
| 1215271085 | Emmanuel Castro | Counselor | 4 Village Loop, Phillips Ranch, CA 91766 | 2012-11-19 |
| Find all providers in zip 91766 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609859461 | Congregational Homes | Assisted Living Facility | 900 E Harrison Ave, Pomona, CA 91767-2075 | 2005-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588165 | Nana's Garden II | Assisted Living Facility | 25312 Ericson Way, Laguna Hills, CA 92653-5054 | 2020-11-03 |
| 1609476589 | Southbay Care Home, Inc. | Assisted Living Facility | 19917 Anza Avenue, Torrance, CA 90503-2005 | 2020-10-29 |
| 1821697434 | Global Regency Senior Care Services, LLC | Assisted Living Facility | 117 E 8th St, Long Beach, CA 90813-4397 | 2020-10-23 |
| 1689273419 | Pacifica Slo LLC | Assisted Living Facility | 475 Marsh St, San Luis Obispo, CA 93401-6108 | 2020-10-22 |
| 1871192682 | Pacifica Sfo LLC | Assisted Living Facility | 624 Laguna St, San Francisco, CA 94102-4217 | 2020-10-22 |
| 1528667367 | Pacifica Sierra Vista Lp | Assisted Living Facility | 13815 Rodeo Dr, Victorville, CA 92395-5600 | 2020-10-22 |
| 1992304737 | West Lyons Lp | Assisted Living Facility | 24305 Lyons Ave, Newhall, CA 91321-2344 | 2020-10-22 |
| 1619576451 | Pacifica Orange County LLC | Assisted Living Facility | 2619 Orange Ave, Costa Mesa, CA 92627-4630 | 2020-10-22 |
| 1720687551 | P San Leandro Lp | Assisted Living Facility | 348 W Juana Ave, San Leandro, CA 94577-3661 | 2020-10-22 |
| 1952900730 | Pacifica Daly LLC | Assisted Living Facility | 995 E Market St, Daly City, CA 94014-2168 | 2020-10-22 |
| 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.