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General NPI Number Information
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NPI Number | 1609694116
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Entity Type | Organization
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Legal Business Name | GRACE HEALTHCARE LLC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 5007 BROOKLET WAY
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City | MIDDLETOWN
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State | OH
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Zip | 45042-3595
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Country | US
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Telephone | 585-284-4979
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Fax |
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Provider Business Mailing Address
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Address Line | 5007 BROOKLET WAY
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City | MIDDLETOWN
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State | OH
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Zip | 45042-3595
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Country | US
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Telephone | 585-284-4979
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CYRIL G BOLINJI
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Credential |
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Telephone | 585-284-4979
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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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