Grace Senior Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRACE SENIOR LIVING

Doing business as

Grace House

Practice address

221 SW Yager PL
Port St Lucie, FL 34953-5468

Phone

(772) 812-8749

Fax

(772) 291-6304

NPI assigned

Aug 31, 2021

Last updated

Aug 31, 2021By 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. Leona Claire James, RN, MPHNPI 1679047716

Title

Administrator

Phone

(772) 812-8749

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grace House Doing business as

Electronic endpoints 1

Tax ID family

Grace Senior Living4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Grace Senior Living, LLC

  dba Grace House

  • Developmentally Disabled Services Day Training Agency
  • Port St Lucie, FL
  • NPI 1023889821
  NPD tax ID
• Grace Senior Living, LLC

  dba Grace Manor

  • Assisted Living Facility
  • Port St Lucie, FL
  • NPI 1629735030
  NPD tax ID
• Grace Senior Living, LLC

  dba Grace Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Port St Lucie, FL
  • NPI 1750168977
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leona Claire James, LEONA

  • Assisted Living Facility
  • Port St Lucie, FL
  • NPI 1679047716
  Authorized official Same address or phone

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1326716911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 SW YAGER PL",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349535468",
            "telephone_number": "772-812-8749",
            "fax_number": "772-291-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 SW YAGER PL",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349535468",
            "telephone_number": "772-812-8749",
            "fax_number": "772-291-6304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6755 NW Monoco Ct",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349835339",
            "country_code": "US",
            "telephone_number": "772-812-8749",
            "fax_number": "772-291-6304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRACE SENIOR LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "LEONA",
        "authorized_official_middle_name": "CLAIRE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-812-8749",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MPH"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104232400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "GraceManorPSL@Gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "221 SW Yager Pl",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349535468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Grace House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Albert Henry Goodin Sr., RPH
• Sandra Goodman
• Laure Goss, M.ED.MS-SLP
• Carmen Lisa Goulet, DMD
• Tricia Goulet, APRN
• Grace Senior Living, LLC (Grace House)
• Grace Senior Living, LLC (Grace Manor)
• Grace Senior Living, LLC (Grace Home)
• Nakeem O Grace
• Graces Palaces

• Assisted Living Facility in Port St Lucie, FL
• Providers in Port St Lucie, 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 Aug 31, 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.