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Contact Information

GRACERIDGE INC
3909 HILL DR
JONESBORO, AR72401-8850
 Phone: 870-935-5961
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Attendant Care Provider

3747A0650X
Indicates primary specialty

NPI Profile & details for GRACERIDGE INC

NPI # 1194287425
LBN Legal business name GRACERIDGE INC
Authorized official KELLY GROJEAN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 04/04/2019
Last updated 06/11/2019 - About 7 years ago
Identifiers
AR Medicaid 223545732
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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