NPIMap

Organization Active NPI

Grace Senior Living, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Port St Lucie, FL
National Provider Identifier
1750168977
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
GRACE SENIOR LIVING, LLC
Practice address
2317 SW Webster LN
Port St Lucie, FL 34953-5752
Phone
(772) 812-8749
Fax
(772) 255-2780
NPI assigned
Sep 11, 2023
Organization subpart
Yes
Parent organization
GRACE SENIOR LIVING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Leona C James, RN, MPH
Title
Administrator
Phone
(772) 812-8749

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

2317 SW Webster LN
Port St Lucie, FL 34953-5752

Mailing address

2317 SW Webster LN
Port St Lucie, FL 34953-5752
Phone (772) 812-8749

Other names 1

  • Grace Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grace Senior Living LLC4 organizations share this tax ID, including this one
Part of
Grace Senior Living LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1750168977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 SW WEBSTER LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349535752",
            "telephone_number": "772-812-8749",
            "fax_number": "772-255-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 SW WEBSTER LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349535752",
            "telephone_number": "772-812-8749",
            "fax_number": "772-255-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE SENIOR LIVING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRACE SENIOR LIVING, LLC",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "LEONA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-812-8749",
        "authorized_official_credential": "RN, MPH"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.