Organization Active NPI

Gracie'S Adult Care Home LLC

  • Adult Care Home Facility
  • Salem, OR
National Provider Identifier
1104745058
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
GRACIE'S ADULT CARE HOME LLC
Practice address
326 Carnelia St SE
Salem, OR 97306-2077
Phone
(971) 239-2000
Fax
(503) 339-7927
NPI assigned
Jul 14, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Authorized official

Name
Ms. Lisa Elizabeth BrundidgeNPI 1528910536
Title
Owner
Phone
(971) 239-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

326 Carnelia St SE
Salem, OR 97306-2077

Mailing address

4841 Ranger Ave NE
Salem, OR 97305-4141
Phone (971) 239-2000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1783987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1104745058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4841 RANGER AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973054141",
            "telephone_number": "971-239-2000",
            "fax_number": "503-339-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 CARNELIA ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973062077",
            "telephone_number": "971-239-2000",
            "fax_number": "503-339-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACIE'S ADULT CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "BRUNDIDGE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-239-2000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.