Grand Cypress Court Afl Home LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

GRAND CYPRESS COURT AFL HOME LLC

Practice address

4729 Grand Cypress CT
Raleigh, NC 27604-5877

Phone

(919) 272-2594

Fax

(919) 272-2594

NPI assigned

Jul 31, 2026

Organization subpart

Yes

Parent organization

GRAND CYPRESS COURT AFL HOME LLCAs reported in NPPES

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

Authorized official

Name

Miss Henrietta JohnsonNPI 1245121896

Title

Director

Phone

(919) 272-2594

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Henrietta Johnson

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Raleigh, NC
  • NPI 1245121896
  NPD (past) Authorized official

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

{
    "created_epoch": "1785456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786060800000",
    "number": "1992628630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 GRAND CYPRESS CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276045877",
            "telephone_number": "919-272-2594",
            "fax_number": "919-272-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4729 GRAND CYPRESS CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276045877",
            "telephone_number": "919-272-2594",
            "fax_number": "919-272-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND CYPRESS COURT AFL HOME LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRAND CYPRESS COURT AFL HOME LLC",
        "enumeration_date": "2026-07-31",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "HENRIETTA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-272-2594",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tannetta Nicole Tucker Graham
• Terrence Wayne Graham, MS, LCAS
• Zhen Graham
• Juan Luis Granados, M.D.
• Sarah Lyn Granahan, HTP-A, RMT
• Jeffrey S Grande, PA-C
• Grandfather Home - Raleigh
• Deborah Granick, LCSW, RN, PMHNP
• Andre Grant, MD
• Antoinette Grant

• Assisted Living Facility (Mental Illness) in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Assisted Living Facility (Mental Illness) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.