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General NPI Number Information
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NPI Number | 1154279123
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Entity Type | Organization
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Legal Business Name | THE GRACE HOUSE
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 23800 W 10 MILE RD STE 130
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3182
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Country | US
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Telephone | 248-996-9134
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Fax |
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Provider Business Mailing Address
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Address Line | 23800 W 10 MILE RD STE 130
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3182
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Country | US
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Telephone | 248-996-9134
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/SOCIAL WORKER
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Name | MISS TERRI GRACE COOPER
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Credential | BSW
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Telephone | 248-996-9134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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