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General NPI Number Information
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NPI Number | 1316823784
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Entity Type | Organization
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Legal Business Name | GRACE DIRECT CARE LLC
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 2222 W GRAND RIVER AVE STE A
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City | OKEMOS
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State | MI
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Zip | 48864-1604
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Country | US
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Telephone | 616-600-0823
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 32
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City | GRANDVILLE
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State | MI
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Zip | 49468-0032
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TEDDY AZUBUIKE
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Credential |
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Telephone | 616-606-0823
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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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