Graceland Assisted Living

Organization Active NPI Assisted Living Facility · Garden Ridge, TX

NPI 1508025099 · NPPES record last updated Jun 9, 2008

Key facts

NPI
1508025099
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
License
112410 (TX)
Legal business name
GRACELAND ASSISTED LIVING
Practice address
19095 FM 2252
Garden Ridge, TX 78266-2733
Phone
(210) 651-6377
Fax
(210) 651-0957
NPI assigned
Jun 9, 2008
Organization subpart
No

Authorized official

Name
Mr. Tony Overman
Title
Owner
Phone
(210) 651-4796

National Provider Directory

Locations

19095 FM 2252
Garden Ridge, TX 78266
Phone (210) 651-6377

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 112410 TX Yes

Addresses

Primary practice location

19095 FM 2252
Garden Ridge, TX 78266-2733

Mailing address

19095 FM 2252
Garden Ridge, TX 78266-2733
Phone (210) 651-6377

Other identifiers

IdentifierTypeStateIssuer
112410OtherTXALF LICENSE #

Other providers in Garden Ridge, TX

All providers in Garden Ridge, TX · Assisted Living Facility in Texas

Sources for this page

Verify at the official NPI Registry.