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General NPI Number Information
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NPI Number | 1235047556
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Entity Type | Organization
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Legal Business Name | CHIANTI GRACE LLC
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 9063 CHIANTI CIR
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City | STOCKTON
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State | CA
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Zip | 95212-3816
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Country | US
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Telephone | 209-451-4528
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Fax | 888-927-7518
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Provider Business Mailing Address
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Address Line | 9063 CHIANTI CIR
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City | STOCKTON
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State | CA
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Zip | 95212-3816
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Country | US
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Telephone | 209-451-4528
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Fax | 888-927-7518
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Authorized Official
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Title or Position | LICENSEE / OWNER
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Name | MARICAR MORELOS LAUREL
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Credential |
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Telephone | 209-688-8058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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