Organization
GRACE HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT ISAAC RN (ADMINISTRATOR)
(209) 394-2440
Entity
Organization
Contact information
Practice address
13435 PEACH AVE, LIVINGSTON, CA 95334-9312
(209) 394-2440
(209) 394-8430
Mailing address
13435 PEACH AVE, LIVINGSTON, CA 95334-9312
(209) 394-2440
(209) 394-8430
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
040000171
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR18421F
—
CA
Enumeration date
12/23/2005
Last updated
03/09/2009
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