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General NPI Number Information
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NPI Number | 1437898525
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Entity Type | Organization
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Legal Business Name | GRACE HOME HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 05/27/2022
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 4238 VIVA LANE
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City | INDIANAPOLIS
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State | IN
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Zip | 46239-1911
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Country | US
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Telephone | 317-945-0225
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Fax | 317-961-6099
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Provider Business Mailing Address
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Address Line | 4238 VIVA LANE
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City | INDIANAPOLIS
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State | IN
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Zip | 46239
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Country | US
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Telephone | 317-629-7620
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. EMMANUEL KOLLEH
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Credential |
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Telephone | 317-945-0225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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