Provider Demographics
NPI:1871065508
Name:GRACE OF MONACO LLC
Entity type:Organization
Organization Name:GRACE OF MONACO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMONCITO
Authorized Official - Middle Name:E
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-236-6642
Mailing Address - Street 1:7952 MONACO BAY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2512
Mailing Address - Country:US
Mailing Address - Phone:702-984-6059
Mailing Address - Fax:702-984-6059
Practice Address - Street 1:7952 MONACO BAY CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2512
Practice Address - Country:US
Practice Address - Phone:702-984-6059
Practice Address - Fax:702-984-6059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)