Grace Personal Care Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

EIN Issued in GA

Legal business name

GRACE PERSONAL CARE HOME

Practice address

301 N Forrest St
Valdosta, GA 31601-4838

Phone

(229) 241-8196

Fax

(229) 241-8196

NPI assigned

Jul 7, 2008

Last updated

Jul 21, 2022By 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

Ms. Beverly Brown

Title

Ceo/Administrator

Phone

(229) 241-8196

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1164685566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N FORREST ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316014838",
            "telephone_number": "229-241-8196",
            "fax_number": "229-241-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N FORREST ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316014838",
            "telephone_number": "229-241-8196",
            "fax_number": "229-241-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "229-241-8196",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "EIN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James R. Goss, D.O.
• Destiny Gould
• Ramona Governor, REGISTERED NURSE
• Grace Healthcare Services Inc
• Grace Hospice, LLC (Halcyon Hospice)
• Jennifer Marie Graham, MS, RDN, CSP, LD/N
• Heather Nicole Granger, M.ED., CCC-SLP
• Grant NH LLC
• Anika Grant
• Anna Vaggalis Grant, FNP-C

• Assisted Living Facility in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.