Healthcare Provider Details

I. General information

NPI: 1144957788
Provider Name (Legal Business Name): GRACETOUCH HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21141 SOPHIA DR
MATTESON IL
60443-1869
US

IV. Provider business mailing address

21141 SOPHIA DR
MATTESON IL
60443-1869
US

V. Phone/Fax

Practice location:
  • Phone: 773-629-9754
  • Fax:
Mailing address:
  • Phone: 773-629-9754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MUTIAT KUFORIJI
Title or Position: AGENCY MANAGER/ADMINISTRATOR
Credential:
Phone: 773-629-9754