Graceful Residential LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

GRACEFUL RESIDENTIAL LLC

Practice address

49 Arlington
Arlington Court
Jasper, IN 47546-3552

Phone

(612) 205-1423

NPI assigned

Dec 11, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Richard Ogachi Areba

Title

Ceo

Phone

(612) 205-1423

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1790592012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 ARLINGTON",
            "address_2": "ARLINGTON COURT",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463552",
            "telephone_number": "612-205-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 ARLINGTON",
            "address_2": "ARLINGTON COURT",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463552",
            "telephone_number": "612-205-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL RESIDENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "AREBA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "OGACHI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-205-1423",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Gogel, PA-C
• Anna Marie Goins, OTR-L
• Good Samaritan Hospital
• Gregory K. Gordon, O.D.
• David Lee Graber, PT
• Shawntia Gramelspacher-Zehr, LSW
• Craig J Gramelspacher, O.D.
• Curt E Gramelspacher, O.D.
• Great Heights Physical Therapy
• Greater Jasper School Corporation

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jasper, IN
• Providers in Jasper, IN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.