House of Grace Personal Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

HOUSE OF GRACE PERSONAL CARE HOME

Practice address

80 Jenna LN
Covington, GA 30016-6645

Phone

(404) 549-0877

NPI assigned

Oct 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jean P Stfleur

Title

Administrator

Phone

(404) 549-0877

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1639368129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 JENNA LN",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300166645",
            "telephone_number": "404-549-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JENNA LN",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300166645",
            "telephone_number": "404-549-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF GRACE PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "STFLEUR",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "404-549-0877",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Covington, GA
• Providers in Covington, GA by specialty
• Adult Care Home Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.