Healthcare Provider Details

I. General information

NPI: 1447175286
Provider Name (Legal Business Name): JEWEL GRACE HOUSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N VICTORY RD
NORFOLK NE
68701-6809
US

IV. Provider business mailing address

400 N VICTORY RD
NORFOLK NE
68701-6809
US

V. Phone/Fax

Practice location:
  • Phone: 541-601-0969
  • Fax:
Mailing address:
  • Phone: 541-601-0969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: