Grace Retirement Village, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRACE RETIREMENT VILLAGE, INC.

Practice address

1100 E Whittier Blvd
La Habra, CA 90631-3962

Phone

(562) 694-6515

NPI assigned

Feb 23, 2022

Organization subpart

No

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

Authorized official

Name

Erik T. Doan

Title

Administrator

Phone

(714) 227-9220

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1700532298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E WHITTIER BLVD",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E WHITTIER BLVD",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313962",
            "telephone_number": "562-694-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE RETIREMENT VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "714-227-9220"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in La Habra, CA
• Providers in La Habra, 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 Mar 11, 2022; 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.