Rejuvenate With Grace, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6089 Issued in FL

Legal business name

REJUVENATE WITH GRACE, INC.

Practice address

130 N Tropical TRL
Merritt Island, FL 32953-4737

Phone

(321) 759-4325

Fax

(321) 632-1753

NPI assigned

Apr 13, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Ruth Lynne Grace, L.C.S.W.

Title

President

Phone

(321) 759-4325

Specialties & licenses 1

Addresses

Other names 1

• Licensed Clinical Social Worker Other name

Locations

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1528325610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 561248",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329561248",
            "telephone_number": "321-759-4325",
            "fax_number": "321-632-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N TROPICAL TRL",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534737",
            "telephone_number": "321-759-4325",
            "fax_number": "321-632-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATE WITH GRACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-13",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-759-4325",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "6089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Licensed Clinical Social Worker",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sundeep Raj Rawal, D.M.D.
• Robert C Rawls
• Theresa Regan
• Diane Marie Reid-Van Asdale, OTR/L, CHT
• Yunileydys Reina
• Restoration Medicine LLC
• Diana Harris Revolinski, RN
• Michelle Christina-Lani Reynolds, COTA
• Renee Nicole Reynolds, PTA
• Ricardo a Serrano MD LLC

• Clinical Social Worker in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.