Grace's Garden

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

GRACE'S GARDEN

Practice address

204 Ark Rd Ste 210B
Mount Laurel, NJ 08054-3193

Phone

(856) 222-4313

Fax

(856) 222-4315

NPI assigned

Jan 26, 2023

Last updated

Jan 26, 2023By 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

Nickysha S Johnson

Title

Founder

Phone

(856) 899-2880

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1730895392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 ARK RD STE 210B",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543193",
            "telephone_number": "856-222-4313",
            "fax_number": "856-222-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 ARK RD STE 210B",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543193",
            "telephone_number": "856-222-4313",
            "fax_number": "856-222-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE'S GARDEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NICKYSHA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "856-899-2880"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erynn Shara Gordon, MS
• Nicole Gormley, MS, RD, LDN
• Eli Samuel Goshorn, MD
• Moncia Lynn Goss, M.A., CCC-SLP
• Konstantinos Goulis
• Kathleen Elaine Grafke-Dallos, PT
• Colleen Graham
• Christina Maria Granato
• Irene Grandeza, M.A. BCBA
• Greatlife Wellness Center

• In Home Supportive Care Agency in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• In Home Supportive Care Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.