Abundant Grace Adult & Youth Services

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

ABUNDANT GRACE ADULT & YOUTH SERVICES

Practice address

8430 W Capitol Dr
Milwaukee, WI 53222-1846

Phone

(414) 462-0750

NPI assigned

Jun 29, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Jocelyn Wright Hall, PHD (ABD)

Title

Executive Director

Phone

(414) 248-9271

Specialties & licenses 1

Addresses

Other names 1

• Abundant Grace Adult & Youth Services Former legal business name

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1336719640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8430 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221846",
            "telephone_number": "414-462-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221846",
            "telephone_number": "414-462-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT GRACE ADULT & YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_middle_name": "WRIGHT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "414-248-9271",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHD (ABD)"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abundant Grace Adult & Youth Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.