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General NPI Number Information
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NPI Number | 1720377906
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Entity Type | Organization
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Legal Business Name | GRACE HOSPICE OF GRAND RAPIDS, LLC
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 4959 BROADMOOR AVE SE SUITE 130
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City | KENTWOOD
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State | MI
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Zip | 49512-5300
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Country | US
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Telephone | 616-432-2050
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Fax | 855-618-6652
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Provider Business Mailing Address
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Address Line | 103 FORREST CROSSING BLVD STE 101
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City | FRANKLIN
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State | TN
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Zip | 37064-5454
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Country | US
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Telephone | 615-430-2929
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Fax | 855-618-6652
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Authorized Official
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Title or Position | CEO
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Name | ANNA-GENE O'NEAL
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Credential |
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Telephone | 617-596-5278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 1041000123
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License Number State | MI
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