Provider Demographics
NPI:1841240884
Name:A GRACE PLACE ADULT CARE CENTER
Entity Type:Organization
Organization Name:A GRACE PLACE ADULT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-261-0205
Mailing Address - Street 1:8030 STAPLES MILL RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2713
Mailing Address - Country:US
Mailing Address - Phone:804-261-0205
Mailing Address - Fax:804-261-3940
Practice Address - Street 1:8030 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-2713
Practice Address - Country:US
Practice Address - Phone:804-261-0205
Practice Address - Fax:804-261-3940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child