Essence of Grace LLC.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ESSENCE OF GRACE LLC.

Practice address

1258 Cedar Center Dr
Tallahassee, FL 32301-4876

Phone

(850) 629-4599

NPI assigned

Aug 3, 2020

Last updated

Aug 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Casondra Bennett

Title

Director

Phone

(850) 557-9204

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1619587847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 TILLIS LN",
            "city": "CRAWFORDVILLE",
            "state": "FL",
            "postal_code": "323278902",
            "telephone_number": "850-557-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 CEDAR CENTER DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323014876",
            "telephone_number": "850-629-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENCE OF GRACE LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "CASONDRA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-557-9204"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.