MEDICARE: ASHLEY CRACE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1750181384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY CRACE

Provider Business Mailing Address
First Line	:	6114 PARKER DR
Second Line	:
City	:	LAKE
State	:	MI
Zip	:	48632-9217
Country	:	US
Telephone Number	:	989-817-2813
Fax Number	:

Provider Business Practice Location Address
First Line	:	6114 PARKER DR
Second Line	:
City	:	LAKE
State	:	MI
Zip	:	48632-9217
Country	:	US
Telephone Number	:	989-817-2813
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2025
Last Update Date	:	03/13/2025

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Directions to “ ASHLEY CRACE ” Practice Location

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