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General NPI Number Information
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NPI Number | 1104714773
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Entity Type | Organization
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Legal Business Name | GRACE COMMUNITY BASED ADULT SERVICES
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 554 W LANCASTER BLVD
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City | LANCASTER
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State | CA
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Zip | 93534-2534
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Country | US
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Telephone | 818-441-1049
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Fax |
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Provider Business Mailing Address
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Address Line | 554 W LANCASTER BLVD
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City | LANCASTER
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State | CA
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Zip | 93534-2534
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Country | US
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Telephone | 818-441-1049
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RUBINA HAIRAPETIAN
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Credential |
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Telephone | 818-441-1049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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