Grace Assisted Living Facility LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRACE ASSISTED LIVING FACILITY LLC

Practice address

6746 Massachusetts Dr
Lake Worth, FL 33462-3836

Phone

(561) 966-9535

Fax

(561) 966-9535

NPI assigned

Jun 7, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Kettelie Henry, MSN, APRN

Title

Owner

Phone

(561) 254-2352

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1326615600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6746 MASSACHUSETTS DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334623836",
            "telephone_number": "561-966-9535",
            "fax_number": "561-966-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6746 MASSACHUSETTS DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334623836",
            "telephone_number": "561-966-9535",
            "fax_number": "561-966-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE ASSISTED LIVING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "KETTELIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-254-2352",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSN, APRN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Gopeesingh
• Gordon Grenn D.O., P.a.
• Amy Gordon, LCSW
• Marla Goren, M.A./CCC-SLP
• Michael Gott, DMD
• Graceful Home Care Services, LLC
• Gracious Caring Home Health Agency LLC
• Amy Nicole Graham
• Sandra Yamileth Granados Sarabia
• Gladis Esperanza Granados Saravia II

• Assisted Living Facility in Lake Worth, FL
• Providers in Lake Worth, 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 Jun 7, 2021; 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.