Active NPI
Grace Healthcare Services Inc
- Child Intellectual and/or Developmental Disabilities Respite Care
- Valdosta, GA
National Provider Identifier
1902121809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite Care
- License
- 372083530A
- Legal business name
- GRACE HEALTHCARE SERVICES INC
- Practice address
- 1010 Slater Street
Valdosta, GA 31601 - Phone
- (229) 469-4052
- Fax
- (229) 588-4039
- NPI assigned
- Apr 2, 2010
- 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. Cynthia E McDougle
- Title
- Ceo
- Phone
- (229) 269-8880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | 372083530A | GA | Primary |
Addresses
Primary practice location
1010 Slater Street
Valdosta, GA 31601
Mailing address
1010 Slater Street
Valdosta, GA 31601
Phone (229) 469-4052
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 372083530A | Other | GA | PROVIDER ID NUMBER |
| 092-01-106-1 | Other | GA | PERSONAL CARE PERMIT NO |
Other names 1
- McDougle Personal Care Home Inc
National Provider Directory
National Provider Directory- Tax ID family
- Grace Healthcare Services Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Valdosta, GA
- NPI 1942654512
Locations
1010 Slater St
Valdosta, GA 31601
Phone (229) 469-4052
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270166400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1547078400000",
"number": "1902121809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 SLATER STREET",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "31601",
"telephone_number": "229-469-4052",
"fax_number": "229-588-4039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 SLATER STREET",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "31601",
"telephone_number": "229-469-4052",
"fax_number": "229-588-4039"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRACE HEALTHCARE SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-04-02",
"last_updated": "2019-01-10",
"status": "A",
"authorized_official_last_name": "MCDOUGLE",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "229-269-8880",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": "GA",
"license": "372083530A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER ID NUMBER",
"identifier": "372083530A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL CARE PERMIT NO",
"identifier": "092-01-106-1",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "McDougle Personal Care Home Inc",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Valdosta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.