Healthcare Provider Details

I. General information

NPI: 1851215750
Provider Name (Legal Business Name): GRACE IN-HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 N DOUGLASS ST
MALDEN MO
63863-1235
US

IV. Provider business mailing address

1611 N DOUGLASS ST
MALDEN MO
63863-1235
US

V. Phone/Fax

Practice location:
  • Phone: 573-281-5266
  • Fax:
Mailing address:
  • Phone: 573-281-5266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL BURK
Title or Position: CO OWNER
Credential:
Phone: 573-281-5266