Gracemore, LLC

Skilled Nursing Facility · Brunswick, GA

Organization Active NPI

NPI number 1477542991

Practice location

2708 Lee St
Brunswick, GA 31520-4932
Phone
(912) 265-6771
Fax
(912) 264-8988

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NPI record

NPI
1477542991
Entity type
Organization (Type 2)
Enumeration date
October 18, 2005
Last updated
April 13, 2012
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Skilled Nursing Facility Primary 314000000X 10631320 GA

Mailing address

1211 Macon Rd
Ste D
Perry, GA 31069-2679
Phone
(478) 988-1294
Fax
(478) 988-1193

Authorized official

Name
Mr. William C. Davis Jr.
Title
President
Phone
(478) 988-1294

About Gracemore, LLC

Gracemore, LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Skilled Nursing Facility (code 314000000X). The practice location is 2708 Lee St, Brunswick, GA 31520-4932. The NPI number 1477542991 was assigned on October 18, 2005 and the record was last updated on April 13, 2012.

Gracemore, LLC lists a license in the registry: #10631320 (GA) for Skilled Nursing Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Mr. William C. Davis Jr., President.

Frequently asked questions

What is the NPI number of Gracemore, LLC?

The NPI number is 1477542991.

What is the phone number of Gracemore, LLC?

The phone number listed for the practice location is (912) 265-6771.

Where is Gracemore, LLC located?

2708 Lee St, Brunswick, GA 31520-4932.

What is the taxonomy code for Gracemore, LLC?

The primary taxonomy code is 314000000X – Skilled Nursing Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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