Provider Demographics
| NPI: | 1538647052 |
|---|---|
| Name: | GIVING GRACE SHARED LIVING |
| Entity type: | Organization |
| Organization Name: | GIVING GRACE SHARED LIVING |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ADMINISTRATOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CEKEYTRA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | CHAMBERS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 682-564-2349 |
| Mailing Address - Street 1: | 1740 KACHINA LODGE RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | FORT WORTH |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 76131-2418 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 682-564-2349 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 7105 KICKAPOO DR |
| Practice Address - Street 2: | |
| Practice Address - City: | FORT WORTH |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 76179-4710 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 682-564-2349 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2018-08-06 |
| Last Update Date: | 2024-07-28 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
| No | 385H00000X | Respite Care Facility | Respite Care | |
| No | 174200000X | Other Service Providers | Meals | |
| No | 177F00000X | Other Service Providers | Lodging | |
| No | 251B00000X | Agencies | Case Management | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 251E00000X | Agencies | Home Health | |
| No | 251G00000X | Agencies | Hospice Care, Community Based | |
| No | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |
| No | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities | |
| No | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
