Provider Demographics
NPI:1669891511
Name:GRACE WOODS ADULT DAY SERVICE, LLC
Entity type:Organization
Organization Name:GRACE WOODS ADULT DAY SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARUNDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-652-4177
Mailing Address - Street 1:815 YOUNGSTOWN WARREN RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4646
Mailing Address - Country:US
Mailing Address - Phone:330-349-4812
Mailing Address - Fax:330-349-4818
Practice Address - Street 1:815 YOUNGSTOWN WARREN RD
Practice Address - Street 2:SUITE 10
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4646
Practice Address - Country:US
Practice Address - Phone:330-349-4812
Practice Address - Fax:330-349-4818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care