# GRACELAND UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Graceland University SM
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609323245
- **Authorized official:** MOUZON BASS III (AGENT)
- **Authorized official phone:** (972) 367-4845

## Contact information

- **Practice address:** 1 UNIVERSITY PL, LAMONI, IA 50140-1641
- **Practice address phone:** (641) 784-5000
- **Mailing address:** 5050 SPRING VALLEY RD., DALLAS, TX 75244-3909

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 02206 | IA | Yes |

## Other

- **Enumeration date:** 09/01/2016
- **Last updated:** 09/01/2016