Grand Rising Group Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GRAND RISING GROUP HOME LLC

Practice address

3401 21St St SW
Lehigh Acres, FL 33976-3513

Phone

(239) 634-6859

NPI assigned

May 9, 2023

Organization subpart

No

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

Authorized official

Name

Emmanuel Jean, LPN

Title

Owner

Phone

(239) 634-6859

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1992495444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 21ST ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339763513",
            "telephone_number": "239-634-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 21ST ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339763513",
            "telephone_number": "239-634-6859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RISING GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "JEAN",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-634-6859",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon J Kleinpell DPM PA
• Roxana Gordon Marquez
• Sunitha Gowda, MD
• Kelly Graham, LMT
• R John Graham II, LMT
• Grandale Emergency Physicians
• Grettel Graveran Rodriguez
• Dorcas M Gray, RN
• Corinne Michelle Green
• Greenbriar Health Services, LLC

• Adult Care Home Facility in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.