| Organization Name: | AGING GRACE INC. |
| NPI Number: | 1912168758 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHANNON MICHELLE SMITH (OWNER/ADMINISTRATOR) |
| Mailing Address: | 2039 N University Dr Sunrise |
| State: | FL US |
| Postal Code: | 333223936 |
| Phone Number: | 9543570637 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2008 |
| NPI Last Update Date: | 06/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |