Active NPI
Grace Personal Care Services, LLC
- In Home Supportive Care Agency
- Milwaukee, WI
National Provider Identifier
1699072884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Legal business name
- GRACE PERSONAL CARE SERVICES, LLC
- Practice address
- 3246 N Teutonia Ave
Milwaukee, WI 53206-2265 - Phone
- (414) 336-5556
- Fax
- (414) 264-4825
- NPI assigned
- Feb 24, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Lantona T Thornton, RN
- Title
- Director
- Phone
- (414) 336-5556
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
3246 N Teutonia Ave
Milwaukee, WI 53206-2265
Mailing address
PO Box 06221
Milwaukee, WI 53206-0221
Phone (414) 336-5556
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100011394 | Medicaid | WI |
Other names 1
- Grace Supportive Living Services, LLC
National Provider Directory
National Provider Directory- Tax ID family
- Grace Personal Care Services LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Milwaukee, WI
- NPI 1023372190
Locations
3246 N Teutonia Ave
Milwaukee, WI 53206
Phone (414) 264-4824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298505600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1298505600000",
"number": "1699072884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 06221",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532060221",
"telephone_number": "414-336-5556",
"fax_number": "414-264-4825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3246 N TEUTONIA AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532062265",
"telephone_number": "414-336-5556",
"fax_number": "414-264-4825"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRACE PERSONAL CARE SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-02-24",
"last_updated": "2011-02-24",
"status": "A",
"authorized_official_last_name": "THORNTON",
"authorized_official_first_name": "LANTONA",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "414-336-5556",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100011394",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Grace Supportive Living Services, LLC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.