Peace of Grace Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PEACE OF GRACE INC

Practice address

9815 W Riverside Ave
Tolleson, AZ 85353-8585

Phone

(602) 780-0252

Fax

(833) 667-0203

NPI assigned

Sep 16, 2020

Last updated

Sep 16, 2020By 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

Dianna Porter

Title

Ceo

Phone

(480) 561-8554

Specialties & licenses 8

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1326654294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9815 W RIVERSIDE AVE",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538585",
            "telephone_number": "602-780-0252",
            "fax_number": "833-667-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 W RIVERSIDE AVE",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538585",
            "telephone_number": "602-780-0252",
            "fax_number": "833-667-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE OF GRACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-561-8554"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.therapyportal.com/p/peacegrace/",
            "affiliation": "N",
            "endpointDescription": "Client Portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "online client portal",
            "address_1": "9815 W Riverside Ave",
            "city": "Tolleson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853538585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Behavioral Health Agency in Tolleson, AZ
• Providers in Tolleson, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.