Grace Love Recovery

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

GRACE LOVE RECOVERY

Practice address

970 E Corrall St
Avondale, AZ 85323-2757

Phone

(702) 439-1631

NPI assigned

Mar 13, 2024

Last updated

Mar 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dianah Nankunda

Title

Ceo

Phone

(702) 439-1631

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1063271054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 E CORRALL ST",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853232757",
            "telephone_number": "702-439-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 E CORRALL ST",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853232757",
            "telephone_number": "702-439-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE LOVE RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "NANKUNDA",
        "authorized_official_first_name": "DIANAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-439-1631"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.