Grace Friendship Home LLC

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

Legal business name

GRACE FRIENDSHIP HOME LLC

Practice address

4736 NW 5TH Ave
Deerfield Beach, FL 33064-2563

Phone

(954) 401-2806

Fax

(954) 401-2806

NPI assigned

Sep 3, 2025

Organization subpart

No

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

Authorized official

Name

Henrietta G Jackson

Title

Owner

Phone

(954) 401-2806

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1497635338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 SW BOXWOOD CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349536966",
            "telephone_number": "954-401-2806",
            "fax_number": "954-401-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4736 NW 5TH AVE",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330642563",
            "telephone_number": "954-401-2806",
            "fax_number": "954-401-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE FRIENDSHIP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "HENRIETTA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-401-2806"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Day Training/Habilitation Specialist in Deerfield Beach, FL
• Providers in Deerfield Beach, FL by specialty
• Day Training/Habilitation Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.