Grand Life Community Services, Llc.

NPI #1104306109 in Rosenberg, Texas

Provider Information

NPI Number: 1104306109
Entity Type: Organization
Organization Name: Grand Life Community Services, Llc.
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Aug 19, 2018
Last Updated: Aug 19, 2018

Practice Location

Address: 3306 GRAND CANE LN
City: Rosenberg
State: Texas
ZIP Code: 77471-4879
Phone: (979) 618-0331

Authorized Official

Name: BRANDON M RAY
Title: PRESIDENT
Phone: (979) 618-0331

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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