Abundant Grace Care Villa

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ABUNDANT GRACE CARE VILLA

Practice address

9672 Colony St
Anaheim, CA 92804-3475

Phone

(562) 774-6297

Fax

(562) 381-9333

NPI assigned

Oct 2, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Theresa Dompreh-MensahNPI 1912575416

Title

Licensee/Administrator

Phone

(562) 774-6297

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theresa Dompreh-Mensah

  • Assisted Living Facility
  • La Habra, CA
  • NPI 1912575416
  NPD Authorized official

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1699555334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13915 FIDLER AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907062235",
            "telephone_number": "562-774-6297",
            "fax_number": "562-381-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9672 COLONY ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043475",
            "telephone_number": "562-774-6297",
            "fax_number": "562-381-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT GRACE CARE VILLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "DOMPREH-MENSAH",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "LICENSEE/ADMINISTRATOR",
        "authorized_official_telephone_number": "562-774-6297",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noel Abrenica
• Jenaveve Abril
• Shiva Abu Rezeq
• Angel Abuhamad
• Aya Abulebbeh, OD
• Abril Abundes
• Samiha Abusharekh, O.D.
• Abutaleb & Ghanem Chiropractic Inc.
• Taghreed M. Abutaleb, D.C.
• Cynthia Lynett Acaba

• Assisted Living Facility in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.