Healthcare Provider Details

I. General information

NPI: 1417878513
Provider Name (Legal Business Name): SALVATIONGRACECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24010 SPRING WAY DR
SPRING TX
77373-8901
US

IV. Provider business mailing address

24010 SPRING WAY DR
SPRING TX
77373-8901
US

V. Phone/Fax

Practice location:
  • Phone: 832-873-0245
  • Fax:
Mailing address:
  • Phone: 832-873-0245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIENNE OUMBE YONZO EPSE KOMBILA JR.
Title or Position: MANAGER MEMBER
Credential:
Phone: 832-873-0245