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General NPI Number Information
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NPI Number | 1598551061
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Entity Type | Organization
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Legal Business Name | GIVING GRACE HOMES LLC
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Dates
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Enumeration Date | 04/19/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 24210 W VERLEA DR
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City | BUCKEYE
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State | AZ
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Zip | 85326-6082
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Country | US
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Telephone | 480-437-0082
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Fax |
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Provider Business Mailing Address
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Address Line | 14047 W MONTE VISTA RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-5714
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Country | US
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Telephone | 480-437-0082
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RANDY BLAND
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Credential |
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Telephone | 480-437-0082
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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 | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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