Organization Active NPI

Grace, Community Supported Living Services

  • In Home Supportive Care Agency
  • La Crosse, WI
National Provider Identifier
1831854470
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
GRACE, COMMUNITY SUPPORTED LIVING SERVICES
Practice address
4421 Mormon Coulee Rd Ste C
La Crosse, WI 54601-8220
Phone
(608) 963-4357
NPI assigned
Nov 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Authorized official

Name
Ms. Gwen Parr
Title
Co-Owner
Phone
(608) 963-4357

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X Primary
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X

Addresses

Primary practice location

4421 Mormon Coulee Rd Ste C
La Crosse, WI 54601-8220

Mailing address

1815 Redfield St
La Crosse, WI 54601-5862
Phone (608) 963-4357

National Provider Directory

National Provider Directory

Locations

4421 Mormon Coulee Rd
Ste C
La Crosse, WI 54601
Phone (608) 963-4357

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1831854470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 REDFIELD ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015862",
            "telephone_number": "608-963-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 MORMON COULEE RD STE C",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018220",
            "telephone_number": "608-963-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE, COMMUNITY SUPPORTED LIVING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "PARR",
        "authorized_official_first_name": "GWEN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "608-963-4357",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.