# GRANDVILLE'S GROUP HOME, INC

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

## Provider details

- **NPI number:** 1538813852
- **Authorized official:** CHERYL A BOSTON (ADMINISTRATOR)
- **Authorized official phone:** (352) 284-2688

## Contact information

- **Practice address:** 5114 SW 63RD BLVD, GAINESVILLE, FL 32608-3841
- **Practice address phone:** (135) 228-4268
- **Practice address fax:** (352) 505-0026
- **Mailing address:** PO BOX 5721, GAINESVILLE, FL 32627-5721
- **Mailing address phone:** (135) 228-4268
- **Mailing address fax:** (352) 505-0026

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/06/2022
- **Last updated:** 02/06/2022