N/A

LBN: St Grace Manor, Inc
N/A is an health care organization with primary practice located at 804 W 8Th St , Upland CA 91786-6401. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. St Grace Manor, Inc can be contacted via phone (951) 545-4462, or through Haywood, Kathleen Janet via phone (951) 545-4462.

Contact Information

Primary practice address
804 W 8Th St Upland CA 91786-6401
Phone: (951) 545-4462
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Haywood, Kathleen Janet N/A
Phone: (951) 545-4462

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X California

Profile Details

NPI number 1588013528
LBN Legal business name St Grace Manor, Inc
DBA Doing business as N/A
Authorized official Haywood, Kathleen Janet N/A
Entity Organization
Organization subpart 1 No
Enumeration date Jun 10th, 2016
Last updated Jun 10th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588013528 NPPES
California MEDICAID NA

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