Provider Demographics
NPI:1275190043
Name:GRIMSLEY'S GRACE, LLC
Entity Type:Organization
Organization Name:GRIMSLEY'S GRACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:N
Authorized Official - Last Name:GRIMSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-812-8447
Mailing Address - Street 1:PO BOX 826
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34489-0826
Mailing Address - Country:US
Mailing Address - Phone:352-812-8447
Mailing Address - Fax:352-694-2060
Practice Address - Street 1:2331 NE 42ND ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34479-8908
Practice Address - Country:US
Practice Address - Phone:352-812-8447
Practice Address - Fax:352-624-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty