Gracewell Healthcare Corp

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

GRACEWELL HEALTHCARE CORP

Doing business as

Gracewell Residential Home

Practice address

438 N Frederick Ave Ste 215
Gaithersburg, MD 20877-2566

Phone

(301) 990-8311

Fax

(301) 990-8644

NPI assigned

Sep 5, 2024

Last updated

Sep 5, 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

Cynthia Dickson

Title

Ceo

Phone

(301) 990-8311

Specialties & licenses 1

Addresses

Other names 1

• Gracewell Residential Home Doing business as

Locations

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1710712161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 N FREDERICK AVE STE 215",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772566",
            "telephone_number": "301-990-8311",
            "fax_number": "301-990-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 N FREDERICK AVE STE 215",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772566",
            "telephone_number": "301-990-8311",
            "fax_number": "301-990-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEWELL HEALTHCARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-990-8311"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gracewell Residential Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Herbert Bennett Gould, M.D.
• Bryan Gover, D.D.S.
• Grace Hand Incorporated (Graceful Hand Incorporated)
• Grace International Services LLC (GIS Medical & Surgical Supplies)
• Stephen Grace, DDS
• Ahlan Seven Graham
• Amanda Le Grant, PHARMD
• Harold M Graves III, LCSW-C
• Ella Mae Gray, M.A., LCPC
• Georgia Charlotte Gray

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.