Graceful Living Assisted Living LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GRACEFUL LIVING ASSISTED LIVING LLC

Practice address

624 Jones Ferry Rd
Carrboro, NC 27510-2157

Phone

(919) 933-9570

Fax

(919) 933-9572

NPI assigned

Nov 14, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Kuburat Ganiyu, RN

Title

Manager

Phone

(919) 669-8746

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1497579536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 JONES FERRY ROAD",
            "address_2": "PO BOX 99",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "27510",
            "telephone_number": "919-933-9570",
            "fax_number": "919-933-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 JONES FERRY RD",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275102157",
            "telephone_number": "919-933-9570",
            "fax_number": "919-933-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL LIVING ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "GANIYU",
        "authorized_official_first_name": "KUBURAT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "919-669-8746",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Kay Gist, MA, LCMHC
• Jane E Gledhill, CNM
• Elizabeth Jayne Goode, PT
• Whitney Goodman
• Matthew Dale Gouchoe-Hanas, LCSWA
• Krystal Renee' Graves, MS, CRC, LPCA
• Curtis Eugene Gray, MSW, LCSWA
• Diana O. Griffin, P.T.
• Marilyn L Grubbs, LPC
• Rebecca Lynn Grzadzinski, PHD

• Adult Care Home Facility in Carrboro, NC
• Providers in Carrboro, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.