Healthcare Provider Details

I. General information

NPI: 1538294038
Provider Name (Legal Business Name): GRACE LIFECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 11/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LENOIR RD
MORGANTON NC
28655-2666
US

IV. Provider business mailing address

500 LENOIR RD
MORGANTON NC
28655-2666
US

V. Phone/Fax

Practice location:
  • Phone: 828-580-8300
  • Fax: 828-580-8309
Mailing address:
  • Phone: 828-580-8300
  • Fax: 828-580-8309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberNH0476
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License NumberNH0476
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0476
License Number StateNC

VIII. Authorized Official

Name: MRS. BRENDA B. YOST
Title or Position: ADMINISTRATOR
Credential: RN,MSN,LNHA
Phone: 828-580-8326