Graceful Heart LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GRACEFUL HEART LLC

Practice address

2401 W Glendale Ave Ste 102B
Phoenix, AZ 85021-7621

Phone

(602) 880-0323

NPI assigned

Mar 14, 2023

Last updated

Mar 14, 2023By 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

Ibrahim Fofanah

Title

Administrator

Phone

(602) 880-0863

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1477254670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W GLENDALE AVE STE 102B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W GLENDALE AVE STE 102B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217621",
            "telephone_number": "602-880-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL HEART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "FOFANAH",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-880-0863"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Simmons Grace, MD
• Ana Maria Grace, M.D.
• Austin Grace, PA
• R Randall Grace, MD
• Graceful Counseling PLLC
• Graceful Living II
• Graceful Treatment Center LLC
• Graceful Wellness & Essential Nursing LLC
• Gracefull Hands Homecare LLC
• Graceview Behavioral Health LLC

• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.