Healthcare Provider Details

I. General information

NPI: 1043894223
Provider Name (Legal Business Name): GRACE HOME HEALTHCARE & SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4976 OAKLAND DR
LYNDHURST OH
44124-2360
US

IV. Provider business mailing address

4976 OAKLAND DR
LYNDHURST OH
44124-2360
US

V. Phone/Fax

Practice location:
  • Phone: 440-341-4606
  • Fax:
Mailing address:
  • Phone: 440-341-4606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY D CANNADY
Title or Position: OWNER
Credential: RN, MSN, CCM
Phone: 440-341-4606