GRACELAND RESIDENTIAL LLC NPI 1801561873

NPI Information

NPI: 1801561873
Provider Name: GRACELAND RESIDENTIAL LLC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
24220 CHURCH ST
OAK PARK, MI
ZIP 48237
Phone: (520) 336-3026
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GRACELAND RESIDENTIAL LLC is an adult care home custodial care facility in Oak Park, MI. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. GRACELAND RESIDENTIAL LLC NPI is 1801561873. The provider is registered as an organization entity type.

The provider's business location address is:

24220 CHURCH ST
OAK PARK, MI
ZIP 48237-510
Phone: (520) 336-3026

The provider's authorized official is Sidney Atemnkeng .
The authorized official title is Owner and has the following contact phone number (520) 336-3026.

The enumeration date for this NPI number is 8/12/2021 and was last updated on 8/12/2021.

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	311ZA0620X	Custodial Care Facility	Adult Care Home			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: 5/5/2024

NPI Synchronization or Removal

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