Graceland Homes, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

GRACELAND HOMES, LLC

Practice address

603 Ambarella Street
Arlington, TX 76002-7600

Phone

(817) 962-9529

NPI assigned

Jul 20, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angie Lanea Grove

Title

Program Manager/Ceo

Phone

(817) 962-9526

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1043733231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 AMBARELLA ST",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760024505",
            "telephone_number": "817-962-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 AMBARELLA STREET",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760027600",
            "telephone_number": "817-962-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACELAND HOMES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-20",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "GROVE",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "LANEA",
        "authorized_official_title_or_position": "PROGRAM MANAGER/CEO",
        "authorized_official_telephone_number": "817-962-9526"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Arnada Graham

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arlington, TX
• Providers in Arlington, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.