Graceland Residential LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GRACELAND RESIDENTIAL LLC

Practice address

24220 Church St
Oak Park, MI 48237-1510

Phone

(520) 336-3026

NPI assigned

Aug 12, 2021

Last updated

Aug 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sidney Atemnkeng

Title

Owner

Phone

(520) 336-3026

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sidonie Beanju Atemnkeng

  • Home Health Aide
  • Laurel, MD
  • NPI 1932574738
  NPD

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1801561873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24220 CHURCH ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371510",
            "telephone_number": "520-336-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24220 CHURCH ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371510",
            "telephone_number": "520-336-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACELAND RESIDENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "ATEMNKENG",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-336-3026"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Samaritan Comfort Transportation
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• Yousif H Goriel, MD
• Rene Goupayou
• Grace Senior Solutions LLC
• Lyndon Caterra Graham
• Narie Graham, LPN
• Grateful Home Care Mi LLC
• Katherine Greager-Weingarten
• Great Lakes Physical Therapy

• Adult Care Home Facility in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Adult Care Home Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.