Organization
GRACE HOME I
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA JACINTO IBANEZ R.N. (ADMINISTRATOR)
(916) 989-2184
Entity
Organization
Contact information
Practice address
5801 PECAN AVE, ORANGEVALE, CA 95662-4622
(916) 988-6502
(916) 987-1555
Mailing address
108 OAK ROCK CIR, FOLSOM, CA 95630-2016
(916) 989-2184
(916) 987-1555
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
340308436
CA
Other
Enumeration date
10/26/2006
Last updated
06/25/2008
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