NPIMap

Organization Active NPI

Grace Integrated Solutions, LLC

  • Community/Behavioral Health Agency
  • Albuquerque, NM
National Provider Identifier
1477208015
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GRACE INTEGRATED SOLUTIONS, LLC
Practice address
4604 Snapdragon Rd NW
Albuquerque, NM 87120-2752
Phone
(505) 944-6991
NPI assigned
Feb 11, 2022
Last updated
Feb 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Authorized official

Name
Ms. Martha Medina, LCSWNPI 1497328900
Title
Clin Ical Director
Phone
(505) 944-6991

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4604 Snapdragon Rd NW
Albuquerque, NM 87120-2752

Mailing address

4604 Snapdragon Rd NW
Albuquerque, NM 87120-2752
Phone (505) 944-6991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231024002558 NM Part B Supplier - Clinic/Group Practice 3971959156 Receives reassigned benefits from 9 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1477208015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4604 SNAPDRAGON RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871202752",
            "telephone_number": "505-944-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 SNAPDRAGON RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871202752",
            "telephone_number": "505-944-6991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE INTEGRATED SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "CLIN ICAL DIRECTOR",
        "authorized_official_telephone_number": "505-944-6991",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.