Grace Woods Senior Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2425R Issued in OH

Legal business name

GRACE WOODS SENIOR LIVING, LLC

Practice address

730 Youngstown Warren Rd
Niles, OH 44446-3578

Phone

(330) 652-4177

Fax

(330) 652-2295

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Edward J Fabian, N.H.A.

Title

Chief Executive Officer

Phone

(330) 652-4177

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801016639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 YOUNGSTOWN WARREN RD",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444463578",
            "telephone_number": "330-652-4177",
            "fax_number": "330-652-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 YOUNGSTOWN WARREN RD",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444463578",
            "telephone_number": "330-652-4177",
            "fax_number": "330-652-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE WOODS SENIOR LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FABIAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "330-652-4177",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "N.H.A."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2425R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2706521",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evan Goob
• Stacy Goodyear, FNP-C
• Anna Elizabeth Gordon, M.S., CCC-SLP
• Grace Woods Adult Day Service, LLC
• Grace Woods Niles Opco, LLC
• Keri Gradeless, LSW
• Annetta Graham
• Megan Grams
• Heather Gray
• Jessica Gray, PT, DPT

• Assisted Living Facility in Niles, OH
• Providers in Niles, OH by specialty
• Assisted Living Facility in Ohio

• 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.