MEDICARE: SAVED BY GRACE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1992543524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAVED BY GRACE

Provider Business Mailing Address
First Line	:	439 GRAND AVE STE 206
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-3640
Country	:	US
Telephone Number	:	415-955-7713
Fax Number	:

Provider Business Practice Location Address
First Line	:	439 GRAND AVE STE 206
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-3640
Country	:	US
Telephone Number	:	415-955-7713
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. RONNIE MUNIZ SR.
Credential	:
Telephone Number	:	415-955-7713

Provider Enumeration Date	:	07/17/2024
Last Update Date	:	07/17/2024

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Directions to “SAVED BY GRACE ” Practice Location

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