Healthcare Provider Details

I. General information

NPI: 1841240884
Provider Name (Legal Business Name): A GRACE PLACE ADULT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8030 STAPLES MILL RD
RICHMOND VA
23228-2713
US

IV. Provider business mailing address

8030 STAPLES MILL RD
RICHMOND VA
23228-2713
US

V. Phone/Fax

Practice location:
  • Phone: 804-261-0205
  • Fax: 804-261-3940
Mailing address:
  • Phone: 804-261-0205
  • Fax: 804-261-3940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateVA

VIII. Authorized Official

Name: ANGELA K. BECKER
Title or Position: ACCOUNTING ASSISTANT
Credential:
Phone: 804-261-0205