Provider Demographics
NPI:1568040806
Name:GGCC LLC
Entity Type:Organization
Organization Name:GGCC LLC
Other - Org Name:THE GRAND ROYALE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRYTONEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-375-4860
Mailing Address - Street 1:2900 NE KENDALLWOOD PKWY
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64119-1831
Mailing Address - Country:US
Mailing Address - Phone:913-375-4860
Mailing Address - Fax:
Practice Address - Street 1:2900 NE KENDALLWOOD PKWY
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64119-1831
Practice Address - Country:US
Practice Address - Phone:913-375-4860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility