Provider Demographics
NPI:1336949544
Name:GRACEPOINT LIVING, LLC
Entity type:Organization
Organization Name:GRACEPOINT LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TATANESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:947-260-4029
Mailing Address - Street 1:26026 TELEGRAPH RD STE 2001051
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2560
Mailing Address - Country:US
Mailing Address - Phone:847-260-4029
Mailing Address - Fax:
Practice Address - Street 1:21315 FRAZER AVE
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3855
Practice Address - Country:US
Practice Address - Phone:248-835-9053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health