Organization
GRACELAND ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY OVERMAN (OWNER)
(210) 651-4796
Entity
Organization
Contact information
Practice address
19095 FM 2252, GARDEN RIDGE, TX 78266-2733
(210) 651-6377
(210) 651-0957
Mailing address
19095 FM 2252, GARDEN RIDGE, TX 78266-2733
(210) 651-6377
(210) 651-0957
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
112410
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112410
ALF LICENSE #
TX
Enumeration date
06/09/2008
Last updated
06/09/2008
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