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General NPI Number Information
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NPI Number | 1780161406
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Entity Type | Organization
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Legal Business Name | GRACIOUS COMMUNITY HOMES INC
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 3900 JOE RAMSEY BLVD E # 10A
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City | GREENVILLE
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State | TX
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Zip | 75401-7727
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Country | US
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Telephone | 190-360-3901
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Fax | 972-395-1272
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Provider Business Mailing Address
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Address Line | 1233 MUSCOGEE TRL
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City | CARROLLTON
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State | TX
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Zip | 75010-1165
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Country | US
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Telephone | 972-951-1933
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Fax | 972-395-1272
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Authorized Official
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Title or Position | CEO
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Name | ROY A KOSHY
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Credential |
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Telephone | 972-951-1933
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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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