Provider Demographics
NPI:1558507822
Name:SAVING GRACE ADULT DAYCARE
Entity Type:Organization
Organization Name:SAVING GRACE ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:MYTIKA
Authorized Official - Last Name:ROMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-236-5642
Mailing Address - Street 1:100N EXPRESSWAY 77
Mailing Address - Street 2:H-1
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580-4000
Mailing Address - Country:US
Mailing Address - Phone:979-236-5642
Mailing Address - Fax:
Practice Address - Street 1:100N EXPRESSWAY 77
Practice Address - Street 2:H-1
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-4000
Practice Address - Country:US
Practice Address - Phone:979-236-5642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200451311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home