Grell Enterprises, Inc.

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL245 Issued in FL

Legal business name

GRELL ENTERPRISES, INC.

Doing business as

Homestead Retirement Home

Practice address

1117 Massachusetts Ave
Saint Cloud, FL 34769-3787

Phone

(407) 892-3831

Fax

(407) 892-7120

NPI assigned

Apr 29, 2008

Organization subpart

No

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

Authorized official

Name

Paul Chrisler Ellingsworth

Title

President

Phone

(614) 718-0093

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HOMESTEAD RETIREMENT HOME Doing business as

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1811162977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 NEWGATE CT",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430172223",
            "telephone_number": "614-718-0093",
            "fax_number": "614-718-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 MASSACHUSETTS AVE",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347693787",
            "telephone_number": "407-892-3831",
            "fax_number": "407-892-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRELL ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "ELLINGSWORTH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "CHRISLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-718-0093"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140932800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOMESTEAD RETIREMENT HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald W Gray, MD
• Ashley Onet Green, CEO
• Brittni Green, PA-C
• Isaiah Avery Green
• Nathan Andrew Green, BS, PSYCHOLOGY
• Eric Michael Gruber, O.D.
• Eli David Guanipa Paez
• Kara Gucwa
• Kristy Lynn Guetzloe, MOT, OTR/L
• Guiding Light Services LLC

• Assisted Living Facility (Mental Illness) in Saint Cloud, FL
• Providers in Saint Cloud, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.