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General NPI Number Information
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NPI Number | 1881389591
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Entity Type | Organization
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Legal Business Name | LIVING IN GRACE
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Dates
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Enumeration Date | 04/07/2023
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 5900 S LAKE FOREST DR STE 300
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City | MCKINNEY
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State | TX
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Zip | 75070-2238
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Country | US
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Telephone | 469-824-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 S LAKE FOREST DR STE 300
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City | MCKINNEY
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State | TX
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Zip | 75070-2238
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIA COWLES
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Credential |
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Telephone | 708-601-2326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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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 | 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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