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NPI Code Detail

MEDICARE: GRACE PLACE ADULT DAY CENTER LLC

MEDICARE: GRACE PLACE ADULT DAY CENTER 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
1261QA0600XAdult Day Care Clinic/Center750189KY

General Provider Information

NPI Number : 1891170411
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE PLACE ADULT DAY CENTER LLC
Provider Business Mailing Address
First Line : 2100 LIBERTY RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-4319
Country : US
Telephone Number : 859-539-2147
Fax Number :
Provider Business Practice Location Address
First Line : 2100 LIBERTY RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-4319
Country : US
Telephone Number : 859-539-2147
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MS. DG GRIDLEY
Credential : MHA
Telephone Number : 859-539-2147
Provider Enumeration Date : 07/24/2015
Last Update Date : 07/24/2015

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Directions to “GRACE PLACE ADULT DAY CENTER LLC ” Practice Location

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