Graceful Living Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GRACEFUL LIVING INC

Practice address

3709 Corrine LN
Modesto, CA 95356-9407

Phone

(209) 595-0215

NPI assigned

Dec 16, 2020

Last updated

Dec 16, 2020By 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

Mircea Bogdan Condor

Title

Chief Financial Officer

Phone

(209) 595-0215

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1811583537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 CORRINE LN",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569407",
            "telephone_number": "209-595-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 CORRINE LN",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569407",
            "telephone_number": "209-595-0215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1188 Deitz Cir",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "CA",
            "postal_code": "953614505",
            "country_code": "US",
            "telephone_number": "209-595-0215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "580 Buckaroo Ct",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "CA",
            "postal_code": "953618255",
            "country_code": "US",
            "telephone_number": "209-595-0215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "537 Fresian Dr",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "CA",
            "postal_code": "953618295",
            "country_code": "US",
            "telephone_number": "209-595-0215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5708 Amberwood Ln",
            "address_purpose": "LOCATION",
            "city": "Riverbank",
            "state": "CA",
            "postal_code": "953679539",
            "country_code": "US",
            "telephone_number": "209-595-0215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRACEFUL LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "CONDOR",
        "authorized_official_first_name": "MIRCEA",
        "authorized_official_middle_name": "BOGDAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "209-595-0215"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CARE LICENSING",
            "identifier": "LIC507003595",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenell Gowin
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• Grace Home Health & Hospice Inc
• Kimberly Grace
• Nicholas Grace
• Jasmin Gradilla
• Callie C Graham
• Chester Duncan Graham, DC
• Nancy Gisel Grajeda, MSN-FNP
• Daniel Nissim Grajower, MD

• Assisted Living Facility in Modesto, CA
• Providers in Modesto, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.