MEDICARE: EMMANUEL-GRACE HOME HEALTHCARE LLC

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	163WA2000X	Administrator Registered Nurse

General Provider Information

NPI Number	:	1831063619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMMANUEL-GRACE HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	3174 JETSTREAM DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-8802
Country	:	US
Telephone Number	:	614-218-3653
Fax Number	:

Provider Business Practice Location Address
First Line	:	3174 JETSTREAM DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-8802
Country	:	US
Telephone Number	:	614-218-3653
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JANE WANJIKU WARUIRU
Credential	:	RN
Telephone Number	:	614-218-3653

Provider Enumeration Date	:	10/03/2025
Last Update Date	:	10/03/2025

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