Grace Home Assisted Living 1

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

AL6571H Issued in AZ

Legal business name

GRACE HOME ASSISTED LIVING 1

Practice address

2301 S Quail Hollow Dr
Tucson, AZ 85710-7986

Phone

(520) 312-0225

Fax

(520) 207-2223

NPI assigned

Apr 19, 2017

Organization subpart

No

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

Authorized official

Name

Norma Braga

Title

Owner

Phone

(520) 312-0225

Specialties & licenses 5

Addresses

Other identifiers 5

Other names 1

• Grace Home Assisted Living 2 Doing business as

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1760916407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 S QUAIL HOLLOW DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857107982",
            "telephone_number": "520-312-0225",
            "fax_number": "520-207-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S QUAIL HOLLOW DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857107986",
            "telephone_number": "520-312-0225",
            "fax_number": "520-207-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOME ASSISTED LIVING 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "BRAGA",
        "authorized_official_first_name": "NORMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-312-0225"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "AZ",
            "license": "AL6571H",
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "AZ",
            "license": "AL6571H",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AZ",
            "license": "AL6571-H",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AZ",
            "license": "AL7454H",
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": "AZ",
            "license": "AL7454-H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "95188554F13239",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AARP",
            "identifier": "0301305850",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND MUTUAL OF OMAHA",
            "identifier": "85808889",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE  PRIME INSURANCE",
            "identifier": "00416712603",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID AND AARP",
            "identifier": "783517401",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Home Assisted Living 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Disabilities Residential Treatment Facility in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Physical Disabilities Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.