GRACE PLACE COLLIN LLC (NPI# 1306336870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306336870 |
| Entity Type | Organization |
| Organization Name | GRACE PLACE COLLIN LLC |
| Practice Address |
6115 Cupertino Trl Dallas TX 75252-2642 |
| Practice Telephone | 4148394755 |
| Practice Fax Number | 8883207479 |
| Mailing Telephone | 4148394755 |
| Mailing Fax Number | 8883207479 |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | SHANESE MCCLENDON (OWNER) |
| Authorized Official Telephone | 4148394755 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities | ||
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1040 E Lucas Rd, Allen, TX 750027452 | 4148394755 | 8883207479 |
| Street Address |
6115 CUPERTINO TRL |
| City | DALLAS |
| State | TX |
| Zip Code | 75252-2642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457914681 | Lashaun Nicole Mwangi | Counselor | 17740 Preston Rd., Suite 100-b, Dallas, TX 75252 | 2019-04-14 |
| 1699244921 | Naomi Silva | Counselor | 18208 Preston Rd. Ste D9-466, Dallas, TX 75252 | 2018-11-15 |
| 1134601560 | Douglas Wayne Barnes | Counselor | 17762 Preston Rd Suite 108, Dallas, TX 75252 | 2018-09-01 |
| 1528548260 | Rhejes Healthcare Services LLC | In Home Supportive Care | 19019 Preston Rd Apt 710, Dallas, TX 75252 | 2018-08-21 |
| 1447759212 | Quadmed Medical Clinics of Texas, P.a. D/b/a Quadmed Medical Grou | Clinic/Center | 17655 Waterview Parkway, Dallas, TX 75252 | 2018-02-07 |
| 1114436862 | Steven Wade Martin | Chiropractor | 17330 Preston Rd., Suite 150a, Dallas, TX 75252 | 2017-09-26 |
| 1053766568 | Helix Health LLC | Clinical Medical Laboratory | 17218 Preston Road, Suite #4200, Dallas, TX 75252 | 2016-05-03 |
| 1144619511 | Bay Crest LLC | Home Health | 18208 Preston Rd Ste 151, Dallas, TX 75252 | 2015-01-22 |
| 1255720579 | Damion P Davis | Counselor | 17210 Campbell Rd, #200, Dallas, TX 75252 | 2015-01-12 |
| 1891109435 | Pediatric Home Healthcare, LLC | Home Health | 17950 Preston Rd # 370, Dallas, TX 75252 | 2014-06-11 |
| Find all providers in zip 75252 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995387 | Red Maple Residential Care, LLC | Custodial Care Facility | 7111 Blackwillow Ln, Dallas, TX 75249-1427 | 2019-01-10 |
| 1356716682 | Raquel Long | Custodial Care Facility | 210 W Pembroke Ave, Dallas, TX 75208-6727 | 2015-12-11 |
| 1851711253 | Romelias Caring Hands | Custodial Care Facility | 10415 Channel Dr, Dallas, TX 75229-4920 | 2014-04-24 |
| 1578808432 | Another Chance Youth Ministry | Custodial Care Facility | 1622 S Beckley Ave, Dallas, TX 75224-2004 | 2012-12-04 |
| 1356553838 | Cox Adult Foster Home | Custodial Care Facility | 8717 Blossom Lane, Dallas, TX 75227 | 2007-05-04 |
| 1164646626 | Christian Heights Community Care, Inc | Custodial Care Facility | 4708 Wadsworth Dr, Dallas, TX 75216-7339 | 2007-04-13 |
| 1760538052 | Regina A. Johnson | Custodial Care Facility | 6125 Singing Hills Dr, Dallas, TX 75241-2630 | 2007-01-27 |
| 1831287994 | Secure Haven Adult Day Care, Inc. | Custodial Care Facility | 2837 W Illinois Ave, Dallas, TX 75233-1005 | 2006-10-11 |
| 1508260886 | A Home of Your Own | Custodial Care Facility | 9822 Amberton Pkwy, Dallas, TX 75243-2016 | 2014-10-15 |
| 1578982849 | Sharel Sullivan | Custodial Care Facility | 12248 China Lake Dr, Dallas, TX 75253-3045 | 2014-04-15 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.