Grace Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

040000171 Issued in CA

Legal business name

GRACE HOME, INC.

Practice address

13435 Peach Ave
Livingston, CA 95334-9312

Phone

(209) 394-2440

Fax

(209) 394-8430

NPI assigned

Dec 23, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Robert Isaac, RN

Title

Administrator

Phone

(209) 394-2440

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236556800000",
    "number": "1750368387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13435 PEACH AVE",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953349312",
            "telephone_number": "209-394-2440",
            "fax_number": "209-394-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13435 PEACH AVE",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953349312",
            "telephone_number": "209-394-2440",
            "fax_number": "209-394-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2009-03-09",
        "status": "A",
        "authorized_official_last_name": "ISAAC",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-394-2440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "040000171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR18421F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmin Gill, LPCC
• GKN RX
• GKN RX
• Joseph Gonzales
• Grace Cottage
• Lydia T Grant, FNP
• Evangeline D Guettinger, RN
• Leticia Guillen, LCSW
• Mariana Gumm, ASW
• Jenna Maurer Heath, MD

• Skilled Nursing Facility in Livingston, CA
• Providers in Livingston, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.