Grace Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12849 Issued in FL

Legal business name

GRACE ASSISTED LIVING, LLC

Practice address

22091 Peachland Blvd
Port Charlotte, FL 33954-3352

Phone

(941) 766-7178

Fax

(941) 621-4975

NPI assigned

Jul 5, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Grace H Cooper, RNNPI 1083543383

Title

Owner/Administrator

Phone

(941) 766-7178

Specialties & licenses 2

Addresses

Practitioners 1

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

• Grace H Cooper

  • Home Health Agency
  • Port Charlotte, FL
  • NPI 1083543383
  NPD (past) Authorized official

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1194177097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16658 SAN EDMUNDO RD",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339554040",
            "telephone_number": "646-220-6106",
            "fax_number": "941-621-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22091 PEACHLAND BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339543352",
            "telephone_number": "941-766-7178",
            "fax_number": "941-621-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "941-766-7178",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12849",
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL12849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Gordon, ARNP
• Vikti Gosalia, M.D.
• Lara Elaine Goulding, APRN
• Gregory Grabowski, DMD
• Grace Angels Home Care LLC
• Jacqueline Gail Gragg
• Christie Lynn Graham, APRN
• Feytara Graham, MA, LPC, LMHC
• Ashley Marie Graner
• Paul B. Graniero, M.D.

• Assisted Living Facility in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.