Great Grace Adult Family Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GREAT GRACE ADULT FAMILY HOME LLC

Practice address

12305 N Belgard LN
Mead, WA 99021-4501

Phone

(509) 414-9187

Fax

(509) 984-4376

NPI assigned

Oct 21, 2026

Last updated

Oct 21, 2026By 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

George Kimone

Title

Owner

Phone

(509) 418-7485

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1792540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792540800000",
    "number": "1689571952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12305 N BELGARD LN",
            "city": "MEAD",
            "state": "WA",
            "postal_code": "990214501",
            "telephone_number": "509-414-9187",
            "fax_number": "509-984-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12305 N BELGARD LN",
            "city": "MEAD",
            "state": "WA",
            "postal_code": "990214501",
            "telephone_number": "509-414-9187",
            "fax_number": "509-984-4376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5123 E Lane Park Ct",
            "address_purpose": "LOCATION",
            "city": "Mead",
            "state": "WA",
            "postal_code": "990219026",
            "country_code": "US",
            "telephone_number": "509-808-2683",
            "fax_number": "509-472-7458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREAT GRACE ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-21",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A",
        "authorized_official_last_name": "KIMONE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-418-7485"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Mead, WA
• Providers in Mead, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.