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General NPI Number Information
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NPI Number | 1215216742
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Entity Type | Organization
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Legal Business Name | HIS GRACE HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 08/15/2011
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 9013 FRIENDSWOOD DR
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City | FORT WORTH
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State | TX
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Zip | 76123-2723
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Country | US
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Telephone | 817-443-7023
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 N WATSON RD STE 261
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City | ARLINGTON
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State | TX
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Zip | 76006-6258
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Country | US
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Telephone | 817-726-3097
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Fax | 682-206-0797
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROGELIO GALINSUGA
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Credential |
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Telephone | 817-443-7023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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