Grace Covenant Services, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

GRACE COVENANT SERVICES, LLC

Practice address

1600 E Reed Rd
Greenville, MS 38703-7229

Phone

(662) 580-0653

Fax

(662) 580-0569

NPI assigned

Nov 16, 2022

Organization subpart

No

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

Authorized official

Name

Jennifer Johnson, REGISTERED NURSENPI 1427514397

Title

Administrator

Phone

(662) 580-0635

Specialties & licenses 1

Addresses

Other names 1

• Grace Covenant Services, LLC Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Denise Johnson, REGISTERED NURSE

  • Registered Nurse
  • Greenville, MS
  • NPI 1427514397
  NPD Authorized official

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671494400000",
    "number": "1508575895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E REED RD",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037229",
            "telephone_number": "662-580-0653",
            "fax_number": "662-580-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E REED RD",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037229",
            "telephone_number": "662-580-0653",
            "fax_number": "662-580-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COVENANT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-580-0635",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Covenant Services, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Adult Day Care Clinic/Center in Greenville, MS
• Providers in Greenville, MS by specialty
• Adult Day Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.