GRACE COTTAGE NPI 1760710206

NPI Information

NPI: 1760710206
Provider Name: GRACE COTTAGE
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
1616 2ND ST
LIVINGSTON, CA
ZIP 95334
Phone: (209) 394-9676
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GRACE COTTAGE is an intermediate care facility mentally retarded in Livingston, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. GRACE COTTAGE NPI is 1760710206. The provider is registered as an organization entity type.

The provider's business location address is:

1616 2ND ST
LIVINGSTON, CA
ZIP 95334-247
Phone: (209) 394-9676
Fax: (209) 394-7694

The provider's authorized official is Alice Louise Wall .
The authorized official title is Administrator and has the following contact phone number (209) 394-7696.

The enumeration date for this NPI number is 11/20/2009 and was last updated on 11/20/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		550001115	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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