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General NPI Number Information
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NPI Number | 1265972178
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Entity Type | Organization
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Legal Business Name | GRACEFUL IN HOME HEALTHCARE, LLC
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 1500 S 70TH ST STE 104 104
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City | LINCOLN
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State | NE
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Zip | 68506-1574
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Country | US
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Telephone | 402-617-7337
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 S 70TH ST STE 104 104
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City | LINCOLN
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State | NE
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Zip | 68506-1574
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Country | US
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Telephone | 402-617-7337
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | EWONUBARI KEHINDE EREKERE KATS
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Credential | BSN, RN
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Telephone | 402-617-7337
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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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