Provider Demographics
NPI:1538300066
Name:GRACE & GRACE ADULT LIVING CENTER LLC
Entity Type:Organization
Organization Name:GRACE & GRACE ADULT LIVING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VENETTA
Authorized Official - Middle Name:SCHEXNAYDER
Authorized Official - Last Name:LUMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-481-0209
Mailing Address - Street 1:2010 PHILIP ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-2508
Mailing Address - Country:US
Mailing Address - Phone:504-523-2344
Mailing Address - Fax:504-523-2344
Practice Address - Street 1:2010 PHILIP ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-2508
Practice Address - Country:US
Practice Address - Phone:504-523-2344
Practice Address - Fax:504-523-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14136177F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes177F00000XOther Service ProvidersLodgingGroup - Single Specialty