Grace Development Clan Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL034210 Issued in NC

Legal business name

GRACE DEVELOPMENT CLAN INC.

Practice address

3502 Cherry St
Winston Salem, NC 27105-3416

Phone

(336) 480-8369

Fax

(336) 721-1176

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Tonya G Barnes

Title

Administrator

Phone

(336) 480-8369

Specialties & licenses 1

Addresses

Other names 1

• The Dean House Doing business as

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780724484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 CHERRY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271053416",
            "telephone_number": "336-480-8369",
            "fax_number": "336-721-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 CHERRY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271053416",
            "telephone_number": "336-480-8369",
            "fax_number": "336-721-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE DEVELOPMENT CLAN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-480-8369",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL034210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dean House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacklyn Elmore Goza, FNP-C
• Brittany Nicole Graalman, LCSWA
• Grace & Peace
• Grace Community Care Services, LLC
• Grace Concierge and Wellness Services, PLLC
• Brock Grace, LPC
• Graceful Aging Home Care LLC
• Jennifer Lynn Grachen, CRNA
• Denise Marie Grady, APRN
• Jessica Graf, LMT

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.