Grace Full-Care, LLC.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH5213 Issued in AZ

Legal business name

GRACE FULL-CARE, LLC.

Practice address

833 W McLellan Rd
Mesa, AZ 85201-2017

Phone

(602) 380-8243

NPI assigned

Aug 29, 2017

Organization subpart

No

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

Authorized official

Name

Adriana Hernandez

Title

Administrator

Phone

(602) 380-8243

Specialties & licenses 1

Addresses

Other names 1

• McLellan House of Grace Full-Care, LLC. Doing business as

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503964800000",
    "number": "1780101808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 S VAL VISTA DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046401",
            "telephone_number": "480-390-0660",
            "fax_number": "480-396-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 W MCLELLAN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852012017",
            "telephone_number": "602-380-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE FULL-CARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2017-08-29",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-380-8243"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH5213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLellan House of Grace Full-Care, LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maryam Goudarzi
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• Kyle Ann Graber, RN
• Grace & Elegance Assisted Living Home
• Grace a Haynes PC
• Grace Home Health Care, LLC
• Grace Wellness Center LLC
• Graceful Minds PLLC
• Gracestreamscare
• G M Gracey, D.C.

• Community/Behavioral Health Agency in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.