Provider Demographics
NPI:1851976039
Name:GRACE ADULT DAY CENTER LLC
Entity Type:Organization
Organization Name:GRACE ADULT DAY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:VENARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-537-1065
Mailing Address - Street 1:1441 29TH ST STE 115
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1309
Mailing Address - Country:US
Mailing Address - Phone:515-444-8642
Mailing Address - Fax:
Practice Address - Street 1:2690 FLEUR DRIVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50321-5026
Practice Address - Country:US
Practice Address - Phone:515-444-8642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care