# AMAZING GRACE CARE HOMES, INCESIDENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376081810
- **Authorized official:** SHERRI M JEMISON (PRESIDENT)
- **Authorized official phone:** (503) 999-8159

## Contact information

- **Practice address:** 1205 BARNES AVE SE, SALEM, OR 97306-1539
- **Practice address phone:** (503) 999-8159
- **Mailing address:** 6995 SW NYBERG ST, SUITE X201, TUALATIN, OR 97062-7455
- **Mailing address phone:** (503) 999-8159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3104A0630X | Assisted Living Facility (Behavioral Disturbances) | 511482 | OR | Yes |

## Other

- **Enumeration date:** 02/04/2017
- **Last updated:** 02/04/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 500500049 | MARION COUNTY MENTAL HEALTH AFC PROVIDER | OR |