Provider Demographics
NPI:1235890625
Name:GRACEVIEW HOMES
Entity Type:Organization
Organization Name:GRACEVIEW HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-259-9068
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:SHERRILLS FORD
Mailing Address - State:NC
Mailing Address - Zip Code:28673-0058
Mailing Address - Country:US
Mailing Address - Phone:919-259-9068
Mailing Address - Fax:
Practice Address - Street 1:300 W J ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-3540
Practice Address - Country:US
Practice Address - Phone:704-325-3026
Practice Address - Fax:704-325-3378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility