Organization Active NPI

House of Grace LLC

  • Community/Behavioral Health Agency
  • Huntington, WV
National Provider Identifier
1609333830
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HOUSE OF GRACE LLC
Practice address
401 Camden Rd
Huntington, WV 25704-2708
Phone
(606) 939-8486
NPI assigned
Feb 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Authorized official

Name
Rose Onyinyechi Uradu, MDNPI 1326050634
Title
Medical Director
Phone
(606) 939-8486

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

401 Camden Rd
Huntington, WV 25704-2708

Mailing address

401 Camden Rd
Huntington, WV 25704-2708
Phone (606) 939-8486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210616000050 WV Part B Supplier - Clinic/Group Practice 5597165357 Receives reassigned benefits from 2 practitioners
Practice locations: Huntington, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2217154House of Grace Treatment Center401 Camden Rd, Huntington, WV 25704Certificate of waiverMar 17, 2027

National Provider Directory

National Provider Directory

Locations

401 Camden Rd
Huntington, WV 25704
Phone (304) 429-5594

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1609333830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CAMDEN RD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257042708",
            "telephone_number": "606-939-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CAMDEN RD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257042708",
            "telephone_number": "606-939-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF GRACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "URADU",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "ONYINYECHI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "606-939-8486",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.