Gray Residential Services, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

GRAY RESIDENTIAL SERVICES, LLC

Practice address

9660 Commerce Dr
Carmel, IN 46032-7641

Phone

(317) 854-5141

Fax

(317) 854-4801

NPI assigned

Oct 10, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Alicia Gray

Title

Ceo/Owner

Phone

(317) 854-5141

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1477063923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9660 COMMERCE DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327641",
            "telephone_number": "317-854-5141",
            "fax_number": "317-854-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9660 COMMERCE DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327641",
            "telephone_number": "317-854-5141",
            "fax_number": "317-854-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY RESIDENTIAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "317-854-5141",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300009019",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura B. Graham, D.D.S.
• Matthew Graham, LMHC
• Michael Granato
• Venessa J Grappi, MT
• Elizabeth A Grasee, MD
• Amanda Gray, NP
• Ashley Taylor Gray, DMD
• Pamela Ann Gray, PA
• Stephanie Gray, PTA
• Patricia A. Grayson, NP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Carmel, IN
• Providers in Carmel, IN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.