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General NPI Number Information
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NPI Number | 1316476195
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Entity Type | Organization
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Legal Business Name | GSGRACE HEALTHCARE SERVICES, INC.
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 06/06/2017
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Provider Practice Location Address
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Address Line | 20635 ABBEY WOODS CT N
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City | FRANKFORT
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State | IL
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Zip | 60423-3181
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Country | US
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Telephone | 815-277-2581
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Fax | 815-277-2581
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Provider Business Mailing Address
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Address Line | 20635 ABBEY WOODS CT N STE 303
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City | FRANKFORT
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State | IL
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Zip | 60423-3191
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Country | US
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Telephone | 815-277-2581
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Fax | 815-277-2581
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEBORAH O AINA
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Credential | RN
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Telephone | 773-627-0241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 4000555
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 3001558
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License Number State | IL
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