Grace of Rosa LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GRACE OF ROSA LLC

Practice address

27317 Manzanita LN Apt 205
Canyon Country, CA 91387-5114

Phone

(619) 874-3443

NPI assigned

Aug 19, 2022

Last updated

Aug 19, 2022By 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

Krystal Janae Blunt, LVN/LPNNPI 1730454984

Title

Ceo-Nurse

Phone

(619) 874-3443

Specialties & licenses 5

Addresses

Other identifiers 2

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.

• Krystal Janae Blunt, LVN

  • Licensed Vocational Nurse
  • Canyon Country, CA
  • NPI 1730454984

  Licensed Practical Nurse

  NPD Authorized official

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1851019210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27317 MANZANITA LN APT 205",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913875114",
            "telephone_number": "619-874-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27317 MANZANITA LN APT 205",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913875114",
            "telephone_number": "619-874-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE OF ROSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "BLUNT",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_middle_name": "JANAE",
        "authorized_official_title_or_position": "CEO-NURSE",
        "authorized_official_telephone_number": "619-874-3443",
        "authorized_official_credential": "LVN/LPN"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF VOCATIONAL NURSING AND PSYCHIATRIC TECHNICIANS",
            "identifier": "718992",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE BOARD OF NURSING",
            "identifier": "246816",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Denise Gilyard
• Mina Wadie Ishak Girgis, PHARM D
• Joy Go Legaspi, NP
• Gods Promise Medical
• Good Shepherd Transport LLC
• Alejandra Green, M.D.
• Neal C Green, DDS
• Carolyn Griffin
• Michelle Nufable Hagen, LMFT
• Frances Mae Hall, LVN

• Home Health Agency in Canyon Country, CA
• Providers in Canyon Country, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.