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General NPI Number Information
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NPI Number | 1467367441
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Entity Type | Organization
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Legal Business Name | GRACE HOME NURSING CARE PROVIDER LLC
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Dates
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Enumeration Date | 08/15/2026
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Last Update Date | 08/15/2026
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Provider Practice Location Address
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Address Line | 655 KILLINGLY ST
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City | JOHNSTON
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State | RI
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Zip | 02919-4059
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Country | US
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Telephone | 401-472-9853
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Fax | 401-472-9852
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Provider Business Mailing Address
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Address Line | 655 KILLINGLY ST
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City | JOHNSTON
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State | RI
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Zip | 02919-4059
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Country | US
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Telephone | 401-472-9853
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Fax | 401-472-9852
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | YOHANNY MERCEDES
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Credential |
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Telephone | 401-472-9853
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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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