MEDICARE: GRACEY GRACE HOMES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1497613715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEY GRACE HOMES LLC

Provider Business Mailing Address
First Line	:	4780 ORLEANS CT APT C
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-8817
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4852 ORLEANS CT APT D
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-8826
Country	:	US
Telephone Number	:	561-767-2726
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESS EWALD
Credential	:
Telephone Number	:	561-767-2726

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/19/2026

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