Gracious Life Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRACIOUS LIFE INC

Practice address

6 Ridgewood CT
Pomona, CA 91766-4830

Phone

(951) 397-3106

NPI assigned

Jul 29, 2019

Organization subpart

No

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

Authorized official

Name

NA Zhao

Title

Cfo

Phone

(818) 267-0352

Specialties & licenses 1

Addresses

Other names 1

• Gracious Life Inc. Former legal business name

Locations

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1710531611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N HAVEN AVE STE 210",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644951",
            "telephone_number": "909-476-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 RIDGEWOOD CT",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664830",
            "telephone_number": "951-397-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACIOUS LIFE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "ZHAO",
        "authorized_official_first_name": "NA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "818-267-0352"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gracious Life Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Nandini Netkal Gowda, M.D.
• Grace Medical Group of the Valley Inc
• Jacob Grace
• Larissa Anne Grace, M.D.
• Kerry Rose Gracia, M.S.W.
• Rosemarie Anne Grady
• Oliver Grages
• Madeleine Gramajo Aponte, PA
• Sandy Charito Gramajo Cifuentes, DMD
• Maria Lizet Granados Sr.

• Assisted Living Facility in Pomona, CA
• Providers in Pomona, 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 Jul 29, 2019; 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.