Provider Demographics
NPI:1083401335
Name:GRACE COTTAGE SENIOR CARE LLC
Entity type:Organization
Organization Name:GRACE COTTAGE SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LIVIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TULBYA
Authorized Official - Suffix:
Authorized Official - Credentials:OPERATOR
Authorized Official - Phone:913-232-1153
Mailing Address - Street 1:7946 W 155TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-3077
Mailing Address - Country:US
Mailing Address - Phone:913-232-1153
Mailing Address - Fax:
Practice Address - Street 1:7946 W 155TH TER
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-3077
Practice Address - Country:US
Practice Address - Phone:913-232-1153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility