Healthcare Provider Details

I. General information

NPI: 1528613965
Provider Name (Legal Business Name): GRACE CARES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 05/25/2020
Certification Date: 05/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4431 EUGENE WAY
DENVER CO
80239-5415
US

IV. Provider business mailing address

4431 EUGENE WAY
DENVER CO
80239-5415
US

V. Phone/Fax

Practice location:
  • Phone: 720-327-6860
  • Fax:
Mailing address:
  • Phone: 720-327-6860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MEKETE SUGEBO
Title or Position: DIRECTOR
Credential:
Phone: 720-327-6860