NPIMap

Organization Active NPI

Amazing Grace Health Care LLC

  • Developmental Disabilities Clinic/Center
  • White Plains, MD
National Provider Identifier
1730955618
Registry record updated Dec 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
AMAZING GRACE HEALTH CARE LLC
Practice address
5135 Brideshead CT
White Plains, MD 20695-3186
Phone
(202) 390-7313
NPI assigned
Nov 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2023

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

Authorized official

Name
Dr. Binette Forzong Fonge, PHDNPI 1689935223
Title
President
Phone
(202) 390-7313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

5135 Brideshead CT
White Plains, MD 20695-3186

Mailing address

5135 Brideshead CT
White Plains, MD 20695-3186
Phone (202) 390-7313

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701475200000",
    "number": "1730955618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5135 BRIDESHEAD CT",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953186",
            "telephone_number": "202-390-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5135 BRIDESHEAD CT",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953186",
            "telephone_number": "202-390-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING GRACE HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A",
        "authorized_official_last_name": "FONGE",
        "authorized_official_first_name": "BINETTE",
        "authorized_official_middle_name": "FORZONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-390-7313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.