Organization Active NPI

Graceson Manor

  • Assisted Living Facility
  • Reidsville, NC
National Provider Identifier
1346412467
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GRACESON MANOR
Practice address
116 Gwynn Dr
Reidsville, NC 27320-8710
Phone
(336) 349-3610
Fax
(336) 349-4531
NPI assigned
Mar 28, 2008
Organization subpart
Yes
Parent organization
ANCHORED HUMAN SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Ms. Christy L Gwynn
Title
Adminastrator
Phone
(336) 349-3610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

116 Gwynn Dr
Reidsville, NC 27320-8710

Mailing address

116 Gwynn Dr
Reidsville, NC 27320-8710
Phone (336) 349-3610

National Provider Directory

National Provider Directory
Tax ID family
Ashlee Place4 organizations share this tax ID, including this one
Part of
Cornerstone Assisted Living

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1346412467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 GWYNN DR",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208710",
            "telephone_number": "336-349-3610",
            "fax_number": "336-349-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 GWYNN DR",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208710",
            "telephone_number": "336-349-3610",
            "fax_number": "336-349-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACESON MANOR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANCHORED HUMAN SERVICES LLC",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "GWYNN",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINASTRATOR",
        "authorized_official_telephone_number": "336-349-3610",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.