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General NPI Number Information
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NPI Number | 1366452633
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Entity Type | Organization
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Legal Business Name | GRACON, INC.
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 358 HIGHWAY 5 N
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3039
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Country | US
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Telephone | 870-425-2446
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Fax | 870-424-2223
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Provider Business Mailing Address
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Address Line | 358 HIGHWAY 5 N
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3039
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Country | US
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Telephone | 870-425-2446
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Fax | 870-424-2223
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. GAYLA D GRAY
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Credential |
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Telephone | 870-425-2446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 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 #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | AR4607
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License Number State | AR
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