Grace Villa Facility LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL8445 Issued in FL

Legal business name

GRACE VILLA FACILITY LLC

Doing business as

Grace Manor

Practice address

321 E Harvard Street
Orlando, FL 32804

Phone

(407) 895-8418

Fax

(407) 895-8229

NPI assigned

Aug 15, 2012

Last updated

Aug 15, 2012By 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

Hafeez Rahaman Ali

Title

Administrator

Phone

(407) 895-8418

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grace Manor Doing business as

Tax ID family

Grace Manor Ret Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Grace Manor Ret Inc

  dba none

  • Assisted Living Facility
  • Orlando, FL
  • NPI 1841457488
  NPD tax ID

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1427306844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 E HARVARD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045526",
            "telephone_number": "407-895-8418",
            "fax_number": "407-895-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E HARVARD STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "407-895-8418",
            "fax_number": "407-895-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE VILLA FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "HAFEEZ",
        "authorized_official_middle_name": "RAHAMAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-895-8418"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL8445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "675965300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grace Dental, P.a.
• Grace Eyecare LLC
• Grace Manor Ret Inc (none)
• Grace Pharmspa, LLC (Grace PharmSpa)
• Grace Villa Alf
• Melissa Grace, OTR/L
• Taffy Irene Grace, MSN, APRN, CPNP-PC
• Tanner Michael Grace, OD
• Grace's Place Alf LLC
• Graceful Care LLC

• Assisted Living Facility in Orlando, FL
• Providers in Orlando, 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 15, 2012; 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.