Precious Grace Health Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PRECIOUS GRACE HEALTH SERVICES LLC

Practice address

500 North Main St.
Suite a Second FL. #203
Randolph, MA 02368

Phone

(617) 592-9066

NPI assigned

Jul 26, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Olumide Adelu

Title

Ceo

Phone

(617) 592-9066

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1629704390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023680005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NORTH MAIN ST.",
            "address_2": "SUITE A SECOND FL. #203",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "02368",
            "telephone_number": "617-592-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECIOUS GRACE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "ADELU",
        "authorized_official_first_name": "OLUMIDE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-592-9066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.