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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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