Organization
GRACE SENIOR LIVING, LLC
Active
Parent organization
GRACE SENIOR LIVING, LLC
Other names
Grace Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRACE SENIOR LIVING, LLC
Authorized official
LEONA C JAMES RN, MPH (ADMINISTRATOR)
(772) 812-8749
Entity
Organization
Contact information
Practice address
2317 SW WEBSTER LN, PORT ST LUCIE, FL 34953-5752
(772) 812-8749
(772) 255-2780
Mailing address
2317 SW WEBSTER LN, PORT ST LUCIE, FL 34953-5752
(772) 812-8749
(772) 255-2780
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/11/2023
Last updated
09/14/2023
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