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General NPI Number Information
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NPI Number | 1215459193
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Entity Type | Organization
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Legal Business Name | GRACE HOMESTEAD LLC
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 6604 HERBERT RD
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City | COLLEYVILLE
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State | TX
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Zip | 76034-7239
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Country | US
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Telephone | 469-235-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 6604 HERBERT RD
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City | COLLEYVILLE
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State | TX
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Zip | 76034-7239
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Country | US
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Telephone | 469-235-7900
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. GAIL GUDZA
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Credential |
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Telephone | 469-235-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 102479
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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Taxonomy #9
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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 #10
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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