| Organization Name: | GRACELAND ASSISTED LIVING |
| NPI Number: | 1508025099 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TONY OVERMAN (OWNER) |
| Mailing Address: | 19095 Fm 2252 Garden Ridge |
| State: | TX US |
| Postal Code: | 782662733 |
| Phone Number: | 2106516377 |
| Fax Number: | 2106510957 |
| NPI Enumeration Date: | 06/09/2008 |
| NPI Last Update Date: | 06/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 310400000X |
| License Number: | 112410 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |