White Grape Community Services LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

WHITE GRAPE COMMUNITY SERVICES LLC

Practice address

92376 E Rd
Astoria, OR 97103-6610

Phone

(310) 734-9895

NPI assigned

Aug 29, 2023

Last updated

Oct 31, 2024By 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

Quanisha Thomas

Title

Owner

Phone

(310) 734-9895

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1699550434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92376 E RD",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971036610",
            "telephone_number": "310-734-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92376 E RD",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971036610",
            "telephone_number": "310-734-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE GRAPE COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "QUANISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-734-9895"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexxis Weeks, CRM
• Lucas Wenker, MS, LPC
• Nena West
• Mariah Rose Wharton, CNM, DNP
• Allison Whisenhunt, MSW, LCSW
• Debra Kaye White, FNP
• David Wigutoff, PH.D.
• Erik D Williams, CRNA
• Todd M Williams, APRN
• Amber Wilson, PSS

• Medical Specialty Clinic/Center in Astoria, OR
• Providers in Astoria, OR by specialty
• Medical Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.