Healthcare Provider Details

I. General information

NPI: 1841673340
Provider Name (Legal Business Name): GRACE HOME CARE AND REHAB SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24303 WALNUT ST STE 1
NEWHALL CA
91321-2901
US

IV. Provider business mailing address

24303 WALNUT ST STE 1
NEWHALL CA
91321-2901
US

V. Phone/Fax

Practice location:
  • Phone: 407-924-4648
  • Fax:
Mailing address:
  • Phone: 407-924-4648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GIZELA GAW
Title or Position: PRESIDENT
Credential:
Phone: 407-924-4648