A Graceful Place LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

A GRACEFUL PLACE LLC

Practice address

2120 Preston LN
Kissimmee, FL 34746-0018

Phone

(407) 968-5387

NPI assigned

Oct 28, 2021

Organization subpart

No

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

Authorized official

Name

Jacquail Telfair

Title

Owner

Phone

(407) 968-5387

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1629732219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 PRESTON LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347460018",
            "telephone_number": "407-968-5387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 PRESTON LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347460018",
            "telephone_number": "407-968-5387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A GRACEFUL PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "TELFAIR",
        "authorized_official_first_name": "JACQUAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-968-5387"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.