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GRACE OF ROSA LLC NPI 1851019210


NPI Information

NPI: 1851019210
Provider Name: GRACE OF ROSA LLC
Classification: Home Health - 251E00000X
Entity Type: Organization
Address:
27317 MANZANITA LN APT 205
CANYON COUNTRY, CA
ZIP 91387
Phone: (619) 874-3443
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GRACE OF ROSA LLC is a home health in Canyon Country, CA. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. GRACE OF ROSA LLC NPI is 1851019210. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

27317 MANZANITA LN APT 205
CANYON COUNTRY, CA
ZIP 91387-114
Phone: (619) 874-3443

The provider's authorized official is Krystal Janae Blunt .
The authorized official title is Ceo-nurse and has the following contact phone number (619) 874-3443.

The enumeration date for this NPI number is 8/19/2022 and was last updated on 8/19/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1164W00000XLicensed Practical NurseNo
2251B00000XCase ManagementNo
3253Z00000XIn Home Supportive CareNo
4385H00000XRespite CareNo
5251E00000XHome HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1718992OTHERCALIFORNIABOARD OF VOCATIONAL NURSING AND PSYCHIATRIC TECHNICIANS
2246816OTHERARIZONAARIZONA STATE BOARD OF NURSING

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.