GRACE HOME ASSISTED LIVING 1 (NPI# 1760916407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760916407 |
| Entity Type | Organization |
| Organization Name | GRACE HOME ASSISTED LIVING 1 |
| Other Organization Name | GRACE HOME ASSISTED LIVING 2 |
| Practice Address |
2301 S Quail Hollow Dr Tucson AZ 85710-7986 |
| Mailing Address |
2261 S Quail Hollow Dr Tucson AZ 85710-7982 |
| Practice Telephone | 5203120225 |
| Practice Fax Number | 5202072223 |
| Mailing Telephone | 5203120225 |
| Mailing Fax Number | 5202072223 |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | NORMA BRAGA (OWNER) |
| Authorized Official Telephone | 5203120225 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
AL6571H | AZ | Ambulatory Health Care Facilities |
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | AL6571-H | AZ | Residential Treatment Facilities |
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | AL7454H | AZ | Residential Treatment Facilities |
| N | 3747A0650X |
Technician Specialization: Attendant Care Provider |
AL7454-H | AZ | Nursing Service Related Providers |
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | AL6571H | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICAID AND AARP | 783517401 | 01 | |
| AZ | MEDICAID AND MUTUAL OF OMAHA | 85808889 | 01 |
| CA | MEDICAID | 95188554F13239 | 01 |
| AZ | TRICARE PRIME INSURANCE | 00416712603 | 01 |
| AZ | AARP | 0301305850 | 01 |
| Other Name | Type Code |
|---|---|
| Grace Home Assisted Living 2 | Doing Business As Name - Organization |
| Street Address |
2301 S QUAIL HOLLOW DR |
| City | TUCSON |
| State | AZ |
| Zip Code | 85710-7986 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689220691 | Elidia Beas Newbold | Technician | 9122 E. Calle Maria, Tuscon, AZ 85710 | 2019-08-15 |
| 1669934014 | Pain Institute of Southern Arizona (pisa), PC | Pain Medicine | 7140 E Rosewood Street, Suite 110, Tucson, AZ 85710 | 2019-04-04 |
| 1316438351 | Life Aligned Regenerative Medical Center LLC | General Practice | 7920 E Broadway Blvd, Suite 106, Tuscon, AZ 85710 | 2018-05-25 |
| 1497264253 | Beverly Capili | Nurse Practitioner | 6622 East Carondelet Drive, Tucson, AZ 85710 | 2017-09-25 |
| 1629590120 | Linsey Nicole Tomaro | Physician Assistant | 6303 E. Broadway Blvd., Suite 161, Tucson, AZ 85710 | 2017-07-17 |
| 1750803748 | Christopher Sullivan | Podiatrist | 6442 S. Speedway Blvd, Ste 102, Tucson, AZ 85710 | 2017-07-11 |
| 1346762713 | Friday Sika | Respite Care | 8251 E. Kenyon Dr., Tucson, AZ 85710 | 2017-07-07 |
| 1821536228 | Southern Arizona Urgent Care, LLC | Clinic/Center | 6303 E. Broadway Blvd, 161, Tucson, AZ 85710 | 2017-02-06 |
| 1659727816 | Mwangaza Residential Care LLC | Community Based Residential Treatment Facility, Mental Illness | 8421 E. Colette St, Tucson, AZ 85710 | 2016-05-06 |
| 1124494240 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 921 S Prudence Rd, Tucson, AZ 85710 | 2015-08-12 |
| Find all providers in zip 85710 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656651 | Serenity Home Care LLC | Residential Treatment Facility, Physical Disabilities | 6858 S 19th St, Phoenix, AZ 85042-5770 | 2020-10-10 |
| 1073147195 | Armada Group-az, LLC | Residential Treatment Facility, Physical Disabilities | 1612 E. Knoll Circle, Mesa, AZ 85203 | 2020-02-27 |
| 1497385892 | Serenity Home Care LLC | Residential Treatment Facility, Physical Disabilities | 4451 W St Anne Ave, Laveen, AZ 85339-6232 | 2020-01-24 |
| 1023658127 | Carefree Manor Assisted Living LLC | Residential Treatment Facility, Physical Disabilities | 7886 E Breathless Dr, Carefree, AZ 85377 | 2020-01-07 |
| 1497234710 | Sampaguita D. Maglalang | Residential Treatment Facility, Physical Disabilities | My Home Care Adult Assisted Living Facility, LLC., 2607 West Curry Street, Chandler, AZ 85224-1040 | 2018-08-08 |
| 1326533407 | Neuro Rehabcare Scottsdale - Az LLC | Residential Treatment Facility, Physical Disabilities | 7480 E Camino Santo, Scottsdale, AZ 85260-3905 | 2018-06-29 |
| 1356853915 | Pastalino Manor 4 | Residential Treatment Facility, Physical Disabilities | 1421 E Maldonado Dr, Phoenix, AZ 85042-5602 | 2017-11-03 |
| 1770009219 | Neuro Rehabcare of The Valley - Az LLC | Residential Treatment Facility, Physical Disabilities | 8307 W Misty Willow Ln, Peoria, AZ 85383-1511 | 2017-08-16 |
| 1184150484 | Ndg Adult Care Home LLC | Residential Treatment Facility, Physical Disabilities | 1106 W 9th St, Tempe, AZ 85281-5304 | 2017-05-04 |
| 1194198697 | Amanda Ellis | Residential Treatment Facility, Physical Disabilities | 381 East Brook Street, San Tan Valley, AZ 85140 | 2015-11-05 |
| 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.