Healthcare Provider Details

I. General information

NPI: 1134036940
Provider Name (Legal Business Name): GRACE FAMILY AND COMMUNITY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 N GRIMES ST
HOBBS NM
88240-1900
US

IV. Provider business mailing address

2210 W MARLAND ST
HOBBS NM
88240-8641
US

V. Phone/Fax

Practice location:
  • Phone: 575-942-3309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ENEDINA GRACIA
Title or Position: OWNER/PROVIDER
Credential: APRN, MSN, FNP-C
Phone: 575-441-3103