Age With Grace, LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

AGE WITH GRACE, LLC

Practice address

2090 Riverdale Rd
Hood River, OR 97031-8625

Phone

(541) 490-7039

NPI assigned

Sep 22, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Ilea Lynne Bouse, MS CMC

Title

Geriatric Care Manager/Owner

Phone

(541) 490-7039

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1740598945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1767 12TH ST # 199",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970319531",
            "telephone_number": "541-490-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 RIVERDALE RD",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970318625",
            "telephone_number": "541-490-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE WITH GRACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "BOUSE",
        "authorized_official_first_name": "ILEA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "GERIATRIC CARE MANAGER/OWNER",
        "authorized_official_telephone_number": "541-490-7039",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS CMC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Hood River, OR
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.