Grandville'S Group Home, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

GRANDVILLE'S GROUP HOME, INC

Practice address

5114 SW 63Rd Blvd
Gainesville, FL 32608-3841

Phone

(135) 228-4268

Fax

(352) 505-0026

NPI assigned

Feb 6, 2022

Organization subpart

No

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

Authorized official

Name

Cheryl A Boston

Title

Administrator

Phone

(352) 284-2688

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1644105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644105600000",
    "number": "1538813852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5721",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326275721",
            "telephone_number": "135-228-4268",
            "fax_number": "352-505-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 SW 63RD BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326083841",
            "telephone_number": "135-228-4268",
            "fax_number": "352-505-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDVILLE'S GROUP HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-06",
        "last_updated": "2022-02-06",
        "certification_date": "2022-02-06",
        "status": "A",
        "authorized_official_last_name": "BOSTON",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-284-2688"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney B Graham, PHARMD
• Timothy-John Grainger-Rousseau, BPHARM, PHD, RPH
• Joseph R Grajo, MD
• Ralph R Grams, MD
• Lauren Elizabeth Grandpre, M.D.
• Edna G Granger, R.N.
• Krystin Granger, D.O.
• Ashley G Grant, ARNP
• Heidi Grant
• Jennifer Elizabeth Grant

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.