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General NPI Number Information
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NPI Number | 1295885077
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Entity Type | Organization
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Legal Business Name | ALL BY GRACE HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 05/05/2009
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Provider Practice Location Address
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Address Line | 1402 CORINTH ST SUITE 113
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City | DALLAS
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State | TX
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Zip | 75215-2111
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Country | US
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Telephone | 214-550-0215
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Fax | 214-550-0885
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Provider Business Mailing Address
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Address Line | 1402 CORINTH ST SUITE 113
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City | DALLAS
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State | TX
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Zip | 75215-2111
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Country | US
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Telephone | 214-550-0215
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Fax | 214-550-0885
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JENNIFER OLABISI SAMUELS
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Credential | RN
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Telephone | 214-550-0215
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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 | 010939
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License Number State | TX
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