Active NPI
Grace, Community Supported Living Services
- In Home Supportive Care Agency
- La Crosse, WI
National Provider Identifier
1831854470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Primary | ||
| Home Health Aide | 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 DirectoryLocations
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.