# GRACE SENIOR LIVING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GRACE SENIOR LIVING, LLC
- **Other names:** Grace Home
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1750168977
- **Legal business name:** GRACE SENIOR LIVING, LLC
- **Authorized official:** LEONA C JAMES RN, MPH (ADMINISTRATOR)
- **Authorized official phone:** (772) 812-8749

## Contact information

- **Practice address:** 2317 SW WEBSTER LN, PORT ST LUCIE, FL 34953-5752
- **Practice address phone:** (772) 812-8749
- **Practice address fax:** (772) 255-2780
- **Mailing address:** 2317 SW WEBSTER LN, PORT ST LUCIE, FL 34953-5752
- **Mailing address phone:** (772) 812-8749
- **Mailing address fax:** (772) 255-2780

## Taxonomy

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

## Other

- **Enumeration date:** 09/11/2023
- **Last updated:** 09/14/2023